Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem involvement and the presence of various autoantibodies in the serum, particularly antinuclear antibodies. It most commonly affects women between the ages of 20 and 40. The primary pathological basis of ocular manifestations in SLE is vasculitis involving ocular tissues, which is frequently observed in patients with moderate to severe SLE activity and is often bilateral. Skin lesions on the eyelids may present as slightly elevated or atrophic erythema, pigmentation changes, or depigmentation. The eyelid margins may appear dry with scaling, which can lead to secondary Sjögren's syndrome and marginal corneal ulcers. Approximately 15% of patients experience fundus changes, including optic disc hyperemia and edema as well as ischemic optic neuropathy. During the acute phase, ischemia in the posterior pole of the retina may result in the appearance of cotton-wool spots, which typically resolve during remission. Additional retinal findings may include hemorrhages, edema, and arterial or venous occlusion. Ocular involvement can impair vision, but in most cases, timely treatment for lupus can lead to significant reversal of symptoms.