目的　评价手术疗法和非手术疗法治疗外伤性视神经病变的疗效和影响疗效的临床因素。　方法　回顾分析 40例外伤性视神经病变患者 41只眼分别行以鼻内窥镜下视神经管减压术为主的手术治疗 (2 8例 )和以药物治疗为主的非手术疗法治疗 (12例 )后的视力恢复情况。　结果　治疗前有光感～ 0 .0 2视力者手术治疗组与非手术疗法治疗组的疗效差别不显著 ;手术治疗组术前有光感～ 0 .0 2视力者疗效显著优于术前无光感者 ;手术前病程 7d以内者疗效优于病程 7d以上者。　结论　对于严重的外伤性视神经压迫病变应尽早手术。手术前有无视力及病程长短是影响手术效果的重要因素 ,在受伤后 7d内越早手术治疗效果越好。 Objective To evaluate the efficacy of surgical treatment and non-surgical treatment of traumatic optic neuropathy and clinical factors that influence the curative effect. Methods Forty-eight eyes of 40 patients with traumatic optic neuropathy were treated by nasal endoscopic decompression of optic canal (28 cases) and non-surgical treatment with medication (12 cases ) After the restoration of visual acuity. Results before treatment, there is a sense of light ~ 0 .0 2 visual acuity surgical treatment group and non-surgical treatment group difference was not significant; surgical treatment group preoperative light sense ~ 0 .0 2 visual acuity was significantly better than preoperative Light sensation; within 7d before surgery, the effect is better than the duration of more than 7d. Conclusion For severe traumatic optic nerve compression lesions should be operated as soon as possible. Preoperative visual acuity and duration of the disease is an important factor affecting the surgical results within 7d after injury the sooner the better the surgical treatment.