Although hereditary hemorrhagic telangiectasia is a cause of blood tears from the conjunctival telangiectasias, visual loss from intraocular vascular malformations is a rare complication. We examined 20 patients with hereditary hemorrhagic telangiectasia to determine the prevalence of ocular abnormalities in this disease. Seven patients (35%) had conjunctival telangiectasias and two (10%) had retinal vascular malformations.