Various aspects of optic nerve canal fracture, such as diagnosis, mechanism and management, are reviewed and discussed.In our department during the past 15 years, 53 patients with optic nerve canal fracture were treated by a transmaxillary approach. For statistical analysis, these patients were divided into 2 age groups: adults (over 19 years) and juveniles (under 19). When surgery was performed within 2 weeks after injury, 11 of the 16 adults (69%) and 9 of the 14 juveniles (64%) showed visual improvement. When surgery was performed more than 2 weeks after injury, the improvement rate was still high in the juvenile group (60%), but only 8% in the adult group.These results indicate that decompression surgery is indicated in young patients even more than 2 weeks after injury.