Background: Kaposi sarcoma is an opportunistic disease strongly associated with human immunodeficiency virus (HIV) infection. Although it is often described in HIV-positive patients, it is rare as its first presentation.
Case Report: The case of a 40-year-old Caucasian male presenting with bilateral subconjunctival tumors and hemorrhages is presented. The patient had no prior diagnosis of HIV infection. The clinical diagnosis of Kaposi sarcoma, confirmed by histological examination and a positive test for HIV antibodies, allowed establishing the diagnosis of AIDS. Conjunctival Kaposi sarcoma, discovered by an ophthalmologist, was the very first presentation of AIDS. With surgical resection accompanied by highly active antiretroviral therapy (HAART), the prognosis for Kaposi sarcoma is good.
Conclusions: In case of subconjunctival lesion of unknown origin, one should always consider Kaposi sarcoma. Adequate history taking and precise ophthalmic examination with accessory blood tests and histopathology are obligatory for an accurate diagnosis.

Keywords: Kaposi sarcoma, conjunctival tumor