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1. Starter Item: Meki.
Personally, I have not had many problems with mana(unless I just engaged against the enemy champs)in the lane. She really shouldn't spam her skills too often either. So, I think Doran's Ring is a better starter, as it gives sustainable Mp5 and HP/AP.
2. Will of the Ancients
This probably isn't needed unless you REALLY need to get that aura for your team to take up a slot for your AP Carry. The Spell Vamp just seems pretty useless, and, TBH, the spell vamp counteracts with Karma's innate.
3. Morello's Evil Tome
Ok, yeah, the AP and the Mp5 are good, but I don't think the CDR is really needed. Karma's cooldowns are low enough, and if you DO want CDR, I would prefer Frozen Heart for that.
As for situational items, I think you should add Banshee's Veil, as it has HP/MP, MR, and a really nice Passive.
Just some thoughts and opinions. But, overall, your guide isn't bad. Just a bit of work here and there and it'll be a really good guide. :). GL on improving it(if you're still working on it. Aha).
I have my own way to build Karma that is somewhat similar to this.
There is one thing that I most definitely disagree with though... Karma is not offense? I must tell you that she is absolutely the most offensive support in the entire game. Why? Because she can shield/heal allies while at the same time literally ripping enemies apart.
Clarity and Heal are both good to have as a good support, partially because you are there to support your allies, whether they need mana or health. Teleport is also good to have so you can be there to support. Ghost or Flash can also be very useful, if you play more offensively (I do), but you don't.
I can do basically everything with her (jungle, tank, solo, other things she is actually meant to do, etc...). Some are harder than others, but I must say that she is a very powerful, very versatile champion.
I meant to say "She's not pure offence."
As my first guide that I haven't made many changes to, it's fairly outdated.