History: The patient was a male, 24 years old. He was admitted to the hospital 5 days after a head fall with progressive loss of vision. 5 days ago he fell from a height of 2 m and injured his head with a force on the right frontal area. Examination: photopic vision in the right eye, orbital CT showed fracture of the optic nerve canal. Diagnosis: right traumatic optic neuropathy Surgery: endoscopic transnasal optic nerve decompression surgery Surgical outcome: 2 years follow-up after surgery, patient’s visual acuity was 0.6 with visual field defects. In the endoscopic transnasal optic nerve decompression surgery: orbital CT clearly showed blood accumulation in the pterygoid sinus and fracture of the optic nerve canal. Intraoperatively, a linear fracture of the optic nerve canal was seen.