Unilateral disk edema following tripod fracture repair necessitating optic nerve decompression

Compression of the intracanalicular portion of the optic nerve as a complication of repair of a zygomaticomaxillary fracture is possible in the setting of multiple orbital fractures. This is a case report of optic canal compression of the optic nerve as a results of a delayed repair of a tripod fracture using the lateral approach. This occurred in the setting of a severely fractured orbit and resulted in florid unilateral disk edema, visual loss, and an afferent pupil defect. After optic canal decompression, vision was restored and the disk edema resolved. However, the afferent pupil defect has persisted. This is as yet an unreported complication of zygomaticomaxillary fracture repair.