Lateral orbital wall fractures are extremely rare, of which only a few cases accompanied by visual loss have been reported to have undergone optic nerve decompression via the lateral facial approach since Stanley first applied it to 3 cases of impacted orbital wall fractures. Recently we applied this approach to a 22 year-old woman with lateral orbital wall fracture accompanied by immediate posttraumatic blindness, whose visual acuity improved to the extent of detection of hand motion postoperatively.