Outcome of traumatic optic neuropathy. Comparison between surgical and nonsurgical treatment

34 patients with indirect traumatic optic neuropathy were studied to identify factors affecting outcome and surgical indications. 12 cases (13 eyes = group A) underwent surgery and 24 patients (24 eyes = group B) were managed without surgery. Age, optic canal fracture, visual acuity before treatment (initial visual acuity) and days until surgery (only group A) were employed as variables. Visual acuity improved significantly more in patients with initial visual acuity, hand movement (HM) or better than in those with initial visual acuity for light perception (LP) only or worse. When initial visual acuity was HM or better, vision improved significantly more in patients with surgery than in those without surgery (p = 0.0003 by Mann-Whitney U test). Days until surgery were correlated with visual improvement in patients with visual acuity HM or better. Age and optic canal fracture did not affect visual improvement or influence the decision for or against surgery.