ObjectiveTo investigate the therapeutic efficacy of endoscopic optic nerve decompression in the treatment of traumatic blindness and to evaluate the relevant prognostic factors.MethodsClinical data of 85 cases with traumatic blindness and received endoscopic optic nerve decompression was analyzed retrospectively. Univariate analysis and multiple logistic regression analysis were performed to evaluate the potential prognostic factors.ResultsAfter endoscopic optic nerve decompression, the vision acuity got improved in 38 cases with an effective rate of 44.7%(38/85). Univariate analysis indicated that hemorrhage within the ethmoid and/or sphenoid sinus was significantly associated with unrecovered visual acuity. However, multiple logistic regression analysis identified that an interval from injury to operation of more than 3 days, and hemorrhage within the ethmoid and/or sphenoid sinus were negatively correlated with the therapeutic effect.ConclusionsHemorrhage within the ethmoid and/or sphenoid sinus and an interval from injury to operation of more than 3 days are the risk factors in the visual prognosis of traumatic blindness. Surgical treatment within 3 days after injury may facilitate the improvement of vision acuity in patients with total blindness.