This chapter discusses optic nerve decompression, where indirect injury as traumatic loss of vision which occurs without external or initial ophthalmoscopic evidence of injury to the eye or its nerve. The optic nerve is not a true cranial nerve, but is a fiber tract of brain white matter, where the optic canal contains the optic nerve, ophthalmic artery, postganglionic sympathetic fibers, and meningeal extensions. While the intraorbital segment of the optic nerve is permitted limited motion, the optic nerve is tethered within the optic canal where the optic nerve dura fuse with the periorbita. While 4 percent of optic nerves are dehiscent within the sphenoid sinus, the optic nerve may be present within a posterior ethmoid Onodi cell in up to 25 percent of cases. Patients with a lucid interval of unaffected sight before deterioration have a better prognosis than those with no light perception (NLP) from the time of injury. The International Optic Nerve Trauma Study (IONTS) aimed to provide conclusive data regarding the best pathway for traumatic optic neuropathy (TON) management.