A case of visual loss following cranio-maxillofacial trauma is reported. The patient had a sudden partial blindness associated with a fracture of the roof, medial and lateral orbital walls. Access to the orbit was achieved through a transethmoidal approach using the Howarth-Lynch medial incision and resecting the bone fragments which impinged on the optic nerve. The patient had total return of visual acuity, without surgical complications. The role of orbital and optic decompression in the management of patients with traumatic optic neuropathy is discussed. Its indications are controversial and the procedure should be considered only within the context of the specific needs of the individual patient.