To the Editor.
—The article by Dr Whitcup1 provided an excellent discussion of the ocular manifestations of the acquired immunodeficiency syndrome (AIDS), including cytomegalovirus retinitis and the ocular toxicity associated with several AIDS-related medications. However, the Table listing all of the ocular manifestations of AIDS does not include conjunctival manifestations, which do deserve mention. The predominant conjunctival manifestations of HIV disease are Kaposi sarcoma,2 microvasculopathy,3 nonspecific, mild transient conjunctivitis,2 and microsporidial conjunctivitis-keratoconjunctivitis.4 Conjunctival Kaposi sarcoma and microvasculopathy are by far the most common conjunctival manifestations of AIDS. Kaposi sarcoma represents the more clinically significant entity and usually manifests as a painless, discrete, round subconjunctival mass in the inferior fornix (Figure). Because of its benign presentation and appearance, this conjunctival lesion is easily mistaken for a subconjunctival hemorrhage, foreign body granuloma, or a cavernous hemangioma. In light of the recent report by Kurumety and Lustbader5
Flowers CW, Baker RS. Kaposi Sarcoma of the Conjunctiva. JAMA. 1996;275(20):1545. doi:10.1001/jama.1996.03530440023024