Although the associated ocular pathology to systemic lupus erythematosus is not infrequent, its manifestations and importance can be overlooked by rheumatologists and ophthalmologists. We present the case of a 44-year-old male with a history of systemic lupus erythematosus whose disease started with metamorphopsia and subjective alteration of the visual fields of both eyes, with a marked decrease in visual acuity, secondary to bilateral serous retinal detachment and optic neuropathy. He received systemic corticosteroids, biological therapy and posterior subtenon triamcinolone acetonide injections, showing an improvement in visual acuity. Ophthalmic manifestations should be considered a sign of systemic lupus erythematosus activity, therefore the treatment is essentially systemic, in combinationed with local coadjutant treatment.