• A fourth sign of the presumed ocular histoplasmosis syndrome (POHS), peripheral streak lesions, is added to the common triad of disseminated punchedout atrophic spots, peripapillary atrophy, and macular disciform lesions. The streaks are of variable length, width, and pigmentation. They are almost invariably in the equatorial region and oriented parallel to the ora serrata. Streak lesions were found in 5.0% of patients with the POHS.