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Space Medicine Ophthalmology: Insights from Molecular Observations to the Clinical...
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Space Medicine Ophthalmology: Insights from Molecular Observations to the Clinical Management of Ocular Risks in Microgravity

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Astrobiology".

Deadline for manuscript submissions: 28 November 2025 | Viewed by 2712

Special Issue Editor

Dr. Joshua Ong

E-Mail Website
Guest Editor
Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA
Interests: space medicine; ophthalmology; artificial intelligence

Special Issue Information

Dear Colleagues,

Excellent vision remains one of the most critical human aspects in ensuring safety and success on space missions. Space medicine ophthalmology encompasses the study and management of the broad spectrum of ophthalmic changes/risks that can occur in the extraterrestrial environment. Various anterior segment and posterior segment findings have been observed, including dry eye findings, an increased risk of cataract formation, and spaceflight-associated neuro-ocular syndrome (SANS). SANS has been designated as a “Red Risk” for future planetary missions by NASA and is a high priority for mitigation. Molecular studies have also shown an increase in pro-inflammatory and apoptotic expression in ocular tissue, and mouse space studies have observed corneal bullae with signs of inflammation in the anterior chamber following return to Earth. The extraterrestrial environment introduces various multi-faceted risks to the eye, including fluid shifts, space radiation, lunar regolith, and weightless objects in microgravity. Various ophthalmic imaging techniques, such as optical coherence tomography (OCT), fundus photography, and orbital ultrasound, are available onboard the International Space Station (ISS) and have increased our understanding of microgravity-induced ocular changes. While our understanding of the eye in spaceflight has made incredible strides over the years, there is much still to be explored in this domain regarding the molecular changes, clinical manifestations, and therapeutic management of ocular risks in spaceflight.

In this Special Issue, we will cover all aspects of space medicine ophthalmology, from the molecular understanding to the clinical management of ocular risks. We invite clinicians and researchers in the field to submit original research articles, reviews, case reports, perspectives, and meta-analyses on this critical topic, with the goal of deepening our understanding of the human eye in space and protecting astronauts’ vision during spaceflight.

Dr. Joshua Ong
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • spaceflight
  • space medicine
  • ophthalmology
  • space medicine
  • microgravity
  • cornea
  • retina
  • ocular surface

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Published Papers (3 papers)

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Research

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10 pages, 1555 KiB  
Article
The Effects of Antioxidant Cocktail on Ophthalmological Changes Induced by a 60-Day Head-Down Bed Rest in a Randomized Trial
by Marc Kermorgant, Fanny Varenne, Anne Pavy-Le Traon, Thomas Geeraerts, Lisa Barioulet, Pierre Fournié, Rebecca Billette de Villemeur, Marie-Pierre Bareille, Arnaud Beck, Adrianos Golemis, Inês Antunes, Guillemette Gauquelin-Koch, Vincent Soler and Jean-Claude Quintyn
Life 2024, 14(12), 1598; https://doi.org/10.3390/life14121598 - 4 Dec 2024
Viewed by 895
Abstract
Neuro-ophthalmological changes have been reported after prolonged exposure to microgravity; however, the pathophysiology remains unclear. Furthermore, several countermeasures have been suggested to counteract the side effects of microgravity. The objectives of the present study were twofold: (1) to assess the neuro-ophthalmological impact of [...] Read more.
Neuro-ophthalmological changes have been reported after prolonged exposure to microgravity; however, the pathophysiology remains unclear. Furthermore, several countermeasures have been suggested to counteract the side effects of microgravity. The objectives of the present study were twofold: (1) to assess the neuro-ophthalmological impact of 60 days of head-down bed rest (HDBR) and (2) to determine the potential effects of an antioxidant cocktail. In this case, 20 healthy male subjects completed a 60-day HDBR and were randomly allocated into two groups: a control condition without an antioxidant cocktail (CON) and a condition with an antioxidant cocktail (NUT). The retinal nerve fibre layer thickness (RNFLT) and central retinal thickness (CRT) were assessed with spectral domain optical coherence tomography. The optic nerve sheath diameter (ONSD) was measured by ocular ultrasonography and used to assess indirect changes in the intracranial pressure (ICP). The intraocular pressure (IOP) was assessed by Goldmann applanation tonometry. The CRT tended to be reduced after HDBR. The ONSD was increased at the end and after HDBR. The IOP tended to decrease after HDBR. Finally, the antioxidant cocktail had minor impacts on the ophthalmological changes induced by HDBR. It is worth noting that two participants presented peripapillary edema. Full article
(This article belongs to the Special Issue Space Medicine Ophthalmology: Insights from Molecular Observations to the Clinical Management of Ocular Risks in Microgravity)
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Review

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23 pages, 1237 KiB  
Review
Risk of Permanent Corneal Injury in Microgravity: Spaceflight-Associated Hazards, Challenges to Vision Restoration, and Role of Biotechnology in Long-Term Planetary Missions
by Jainam Shah, Joshua Ong, Ryung Lee, Alex Suh, Ethan Waisberg, C. Robert Gibson, John Berdahl and Thomas H. Mader
Life 2025, 15(4), 602; https://doi.org/10.3390/life15040602 - 4 Apr 2025
Viewed by 523
Abstract
Human space exploration presents an unparalleled opportunity to study life in extreme environments—but it also exposes astronauts to physiological stressors that jeopardize key systems like vision. Corneal health, essential for maintaining precise visual acuity, is threatened by microgravity-induced fluid shifts, cosmic radiation, and [...] Read more.
Human space exploration presents an unparalleled opportunity to study life in extreme environments—but it also exposes astronauts to physiological stressors that jeopardize key systems like vision. Corneal health, essential for maintaining precise visual acuity, is threatened by microgravity-induced fluid shifts, cosmic radiation, and the confined nature of spacecraft living environments. These conditions elevate the risk of corneal abrasions, infections, and structural damage. In addition, Spaceflight-Associated Neuro-Ocular Syndrome (SANS)—while primarily affecting the posterior segment—has also been potentially linked to anterior segment alterations such as corneal edema and tear film instability. This review examines these ocular challenges and assesses current mitigation strategies. Traditional approaches, such as terrestrial eye banking and corneal transplantation, are impractical for spaceflight due to the limited viability of preserved tissues, surgical complexities, anesthetic risks, infection potential, and logistical constraints. The paper explores emerging technologies like 3D bioprinting and stem cell-based tissue engineering, which offer promising solutions by enabling the on-demand production of personalized corneal constructs. Complementary advancements, including adaptive protective eyewear, bioengineered tear substitutes, telemedicine, and AI-driven diagnostic tools, also show potential in autonomously managing ocular health during long-duration missions. By addressing the complex interplay of environmental stressors and biological vulnerabilities, these innovations not only safeguard astronaut vision and mission performance but also catalyze new pathways for regenerative medicine on Earth. The evolution of space-based ophthalmic care underscores the dual impact of space medicine investments across planetary exploration and terrestrial health systems. Full article
(This article belongs to the Special Issue Space Medicine Ophthalmology: Insights from Molecular Observations to the Clinical Management of Ocular Risks in Microgravity)
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Other

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8 pages, 1512 KiB  
Perspective
Could Sleep Be an Antidote to Optic Disc Edema in Astronauts?
by Peter Wostyn and Maiken Nedergaard
Life 2025, 15(2), 183; https://doi.org/10.3390/life15020183 - 26 Jan 2025
Cited by 1 | Viewed by 776
Abstract
A spectrum of neuro-ocular changes has been observed in astronauts during and after prolonged exposure to microgravity on long-duration spaceflights. These changes, collectively referred to as “spaceflight associated neuro-ocular syndrome” (SANS), pose a significant challenge for space agencies as they prepare for future [...] Read more.
A spectrum of neuro-ocular changes has been observed in astronauts during and after prolonged exposure to microgravity on long-duration spaceflights. These changes, collectively referred to as “spaceflight associated neuro-ocular syndrome” (SANS), pose a significant challenge for space agencies as they prepare for future human missions, including a return to the Moon and manned missions to Mars. Optic disc edema, a hallmark feature of SANS, occurs in approximately 70% of astronauts on extended missions. Recent evidence suggests a potential link between poor sleep and the development of optic disc edema in individuals exposed to a spaceflight analog environment, providing critical insights into its underlying pathophysiology. Here, we propose a novel hypothesis: sleep deprivation may increase the risk of microgravity-induced optic disc edema by altering translaminar pressure dynamics and disrupting ocular glymphatic outflow. This perspective offers a new framework for understanding SANS and highlights potential targets to mitigate its risks in the context of human space exploration. Full article
(This article belongs to the Special Issue Space Medicine Ophthalmology: Insights from Molecular Observations to the Clinical Management of Ocular Risks in Microgravity)
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