The ocular manifestations in 65 Japanese human immunodeficiency virus (HIV)-seropositive patients were examined. Based on the cumulative totals, 22 of the cases had acquired immunodeficiency syndrome (AIDS), 17 had AIDS-related complex (ARC), and 35 were asymptomatic carriers (AC), including 4 AIDS cases who had progressed from ARC and 5 ARC cases from AC. Seventy-seven percent of the AIDS cases had ocular manifestations, including cotton-wool spots (50%), retinal hemorrhages (59%), cytomegalovirus retinitis (46%) and pupil abnormalities (14%). The ocular signs were also seen in 71% of the ARC cases and 37% of the AC cases. In Japanese HIV-seropositive patients, ocular manifestations are also as common as in Western HIV-seropositive patients.