Orbital apex syndrome is an uncommon but severe ocular complication of craniomaxillofacial fracture. The optimal treatment strategy for this very rare traumatic syndrome has not been well established. We present a case in which traumatic orbital apex syndrome was caused by direct compression from the displaced fracture segments. Visual and extraocular function both improved quickly after emergency decompression surgery. This case suggests that managing the direct type of traumatic orbital apex syndrome with craniomaxillofacial fracture with a combination of urgent reduction of impinging bone and decompression of affected nerves is an effective strategy.
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