Background: Optic disc swelling is a rare sequela of blunt ocular trauma. Methods: The authors examined three young patients who had an unusual posttraumatic optic neuropathy in which protracted swelling of the optic nerve head was the salient clinical feature. Results: Associated choroidal ruptures in two patients suggested a contrecoup mechanism of injury to the optic nerve at its junction with the globe. All patients had partial recovery of vision over months, concurrent with resolution of the nerve head swelling and development of optic disc pallor. Conclusion: Despite its protracted course, posttraumatic optic disc swelling appears to be associated with a favorable prognosis for visual recovery.