Dude. This guide is perfect. I wish that more people would be able to view it since it is indepth and is very easy on the eye. Incredibly easy to read and gives a good insight on how to play Karma. I do think that you should consider listing Ignite as a potential summoner spell to use. Also, if you want more teamfight presence that you swap out Spellthief's Edge for a talisman of ascension later on in the game.

Nice guide! Easy to read, in-depth, and clearly a lot of hard work was put into it.

However, that being said, you should probably turn on Comment to Vote. This will not only net you a lot of good constructive feedback, but will also prevent people from downvoting your guide simply to raise the rating of their own. Plus, most people who bother to log in and upvote will usually leave a comment anyway.

I play Karma every now and then, so I also wanted to leave tips as to how I play her (and support in general):

• No mention of Ignite? Karma is known as a lane bully for a reason. Establishing dominance in all-ins can be extremely useful, considering how much damage Karma deals already.
• I almost always start 3 Health Potion + Mana Potion. The trinket's cooldown is only 120 seconds, so by coordinating with your ADC you can always maintain full vision coverage of the river. Having the extra pots allows you to play much more aggressive and still sustain in lane for a much longer time.
• Your cheat sheet is super cluttered >_< Try to have only 3 or so items per group and talk about build order/consumables in the notes. This way, you can condense everything into 3-4 rows.
• Personally, I would condense all three builds into a single one, with one item group for example offensive items and another for example defensive. That way, you can minimize the amount of scrolling in the cheat sheet while still laying out all of the options for the reader.
• I would never get Seraph's Embrace. Stacking it takes way too much time, and it doesn't provide any utility for your team if you get Tear of the Goddess early.
• Every now and then, I take a second point into Q at level 3 if the wave is pushing the enemy under tower. Having the extra poke is sometimes better when you can't channel your W for the entire duration, which would be pretty hard to do if the enemy is under tower.

Ehh, that's all I'm going to write. I'll be honest, I didn't really read through the entire guide, but it looked good for the most part to me. If you want me to go more in-depth, let me know :)