The optic canal is a bony channel through the lesser wing of the sphenoid, approximately 8-10 mm long, transmitting the optic nerve and the ophthalmic artery from the middle cranial fossa to the orbit. The canal is bounded superomedially by the body of the sphenoid and laterally by the lesser wing. The two optic canals and the optic chiasm form an H-shaped structure at the base of the skull, with the chiasm lying approximately 10 mm behind the posterior canal openings.
The optic canal is the site of traumatic optic neuropathy when a bony fragment or haematoma compresses the optic nerve within the rigid canal after frontal or fronto-temporal trauma. High-dose corticosteroids or endoscopic optic canal decompression are treatment options for indirect traumatic optic neuropathy. Pituitary macroadenomas, craniopharyngiomas, and sphenoid wing meningiomas may compress the canal or the adjacent optic nerve and chiasm. MRI with orbital fat suppression sequences best evaluates the optic nerve within the canal.
Frontal impact transmits shearing forces through the lesser wing of the sphenoid to the optic canal, contusing or stretching the optic nerve within the rigid bony canal without canal fracture, producing immediate or delayed visual loss managed with high-dose methylprednisolone or endoscopic optic canal decompression.
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