Among the male population who have sex with men (MSM), HIV infection has been shown to be strongly associated with syphilis infection with a prevalence rate reaching as high as 20%. Variations in the clinical manifestation ranges from painless ulcers and maculopapular rash that can progress to more rare and serious complications such as ocular involvement. Although ocular manifestation most commonly occurs in later stages of syphilis, it can also occur in primary and secondary stages and is characterized with sudden loss of vision. We report a case of A 24-year-old male patient with complaints of pruritic erythematous plaque and papules on the scrotum and perianal erosion that also complained sudden loss of vision on his left eye. Laboratory results showed positive non-treponemal and treponemal results along with positive HIV test. Fundoscopy found bilateral optical neuritis. The patient was diagnosed with ocular syphilis in secondary syphilis and HIV infection. The patient received three doses of intramuscular 2.4 million IU benzathine penicillin G injections and experienced improved visual acuity and decreased titters of both non-treponemal and Treponemal tests after three months of follow-up.