Blindness is a serious complication that can occur after facial trauma and may represent the loss of one of the most useful senses in the human relationship with the world—the sight. This study aims to review the pathophysiology of blindness related to facial trauma in order to identify the mechanisms by which it develops and to recognize the signs and symptoms required to establish proper diagnosis and treatment. Blindness following facial trauma may occur due to mechanisms that involve injury to the eyeball, optic nerve and eyelids. The leading causes of blindness resulting from facial trauma, and which may be altered by medical interference, are related to retrobulbar hemorrhage and traumatic optic neuropathy, which require extremely rapid diagnosis and can be accomplished with the resources available in most trauma-based emergency services. The authors conclude that loss of vision tends to be irreversible in direct eyeball and optic nerve lesions, but can be prevented in retrobulbar hemorrhage and traumatic optic neuropathy. Eyeball and, especially, sight accuracy evaluation should be included in the initial care of trauma patients, so that the lesions that might lead to loss of vision are diagnosed and treated early.