The orbital apex syndrome can be caused by trauma. The patient presented was hit by an elbow in the right periorbital area with resulting fractures to the right zygoma and orbital floor. Examination revealed visual loss, total ophthalmoplegia, and ptosis of the right upper eyelid with hypoesthesia in the ophthalmic division of the trigeminal nerve. After a week of supportive therapy and observation, the orbital floor fracture was repaired by reducing the bone fragments, and the zygomatic fracture was reduced through a Gillies incision. Over the next six months, there was complete resolution of the ophthalmoplegia, the ptosis, the loss of sensation in the ophthalmic division of the trigeminal nerve, and the vision.