This chapter provides detail description of Management of acute trauma to the optic nerve. Introduction to management of trauma to optic nerve is given in the beginning. Anatomical features of importance for optic nerve damage, epidemiology and etiology, classification of traumatic optic neuropathy, visual evoked potentials, indications and timing of intervention, conservative therapy, endonasal, transorbital or neurosurgical peritonal decompression, results and dilemma are described in detail. 3 tables are added to highlight classification of traumatic optic neuropathy, evaluation of optic neuropathy and steroid dose classification for optic neuropathy. 35 references are included at the end of the chapter to facilitate further reading.