Optic nerve decompression has been advocated for indirect optic nerve injury; however, the results are not clearly better than expectant management with the exception that documented delayed visual loss appears to be a strong indication for surgery.
Transethmoidal is the accepted route and is usually done within 1–3 weeks from the trauma. use of “megadose steroids” may be appropriate as an adjunct to diagnosis and treatment 1)
Extended endoscopic endonasal approach transsphenoidal-transethmoidal
Endoscopic transethmoidal - transphenoidal - transpterygoid approach