Introduction: Human immunodeficiency virus (HIV) is a retrovirus that causes a multisystem disease namely acquired immunodeficiency syndrome (AIDS). Visual impairment related to HIV could be caused by opportunistic infections in the eye or neuro-ophthalmic axis, vascular abnormalities, neoplasms, and adverse medication effects. Materials and methods: We carried out a retrospective analysis of the clinical, radiological, laboratory, immunovirological, therapeutic, and survival data of 1,480 HIV-positive patients from 2016 to 2022 to look for cases presenting with significant visual loss in one or both eyes attributable to HIV infection at our center. We have presented descriptive details of six such patients in tabular form. Results: Out of the 1,480 people living with HIV/AIDS (PLHA) screened 14 presented with a significant visual loss out of which 10 had cytomegalovirus (CMV) retinitis, two patients had cortical blindness secondary to progressive multifocal leukoencephalopathy (PMLE) one patient each had cryptococcal meningitis, and ocular syphilis. Conclusion: Cytomegalovirus (CMV) retinitis remains the commonest cause of visual loss in PLHA in the combination antiretroviral therapy (cART) era. Neuro-ophthalmic diseases are an important cause of visual loss in HIV infection. Early diagnosis through routine ophthalmologic screening, serological screening for syphilis, and cryptococcal infection of patients with low clusters of differentiation 4 (CD4) is essential to prevent visual loss in these subsets of patients.