Referring to 22 cases of surgery after frontobasal fractures of different origin with loss of vision, the surgical procedure is discussed with special consideration of the approach, technique and timing of the operation. We conclude that the external rhinological approach through the ethmoid sinus is the best and easiest access in cases of loss of vision with verified fracture or haematoma. A number of patients were operated using CAS (Computer Assisted Surgery)-Systems, a CT-based tool for three-dimensional orientation. It proved to be very useful for the surgeon, saving time and reducing the risk of additional damage. According to our experience and the results of other authors we believe that surgical intervention should be performed as early as possible.