Four patients with vision loss due to indirect injury to the optic nerve are presented. In each patient the optic canal was decompressed through an ipsilateral external ethmoidectomy. The patients also received megadose dexamethasone or prednisolone during the perioperative period. Three of the four patients showed some visual improvement and expansion of their visual fields. One patient with initial total blindness showed no vision improvement. There is still controversy about the treatment of traumatic optic neuropathy. We advocate aggressive surgical intervention in the management of this condition even in patients with total blindness.