Clinically, many traumatic injuries can lead to vision loss or even blindness, which, if not treated promptly and effectively, will result in irreversible vision loss and seriously affect the patient’s work, life and study. There are many causes of visual impairment after trauma, except for the eye itself, such as hemorrhage, traumatic cataract, glaucoma, iris inflammation, retinal detachment, etc. (not detailed here), but the damage to the optic nerve is easily overlooked. In addition to direct injury from fractures of the optic nerve canal, damage to the optic nerve is more often due to post-traumatic hemorrhage, edema, or indirect injury from osteoconduction of traumatic forces. The former can be detected by CT thin-section scan of the optic nerve foramina, and the latter can be confirmed by imaging (optic nerve swelling), ocular examination (fundus, OCT, optometry, pupil examination). Of course, there is also vision loss due to lesions in the optic pathway above the intracanalicular segment. Since these patients are usually injured more severely, early life saving is the main focus and eye examination is often neglected, while nerve cells are permanent cells with no regenerative function, so even accurate treatment helps to save further apoptosis of nerve cells that are not yet apoptotic, thus saving vision. Recently, two patients with no light perception (one from Hengyang, Hunan, and one from Loudi, Hunan) were operated by “open decompression of the optic nerve through the pterygoid sinus” after conservative treatment was ineffective, and obtained good results, with postoperative visual acuity of 0.1 and 0.4 respectively. Therefore, such patients, especially those with frontal and temporal injuries, should be given high priority and treated early. Once it occurs, it should be treated early.