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The cornea during spaceflight: a frontier in space medicine ophthalmology

Eye (2024)Cite this article

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Human spaceflight, particularly for long-duration missions, poses significant challenges to astronaut health and well-being. Understanding the impact of spaceflight on the human body is paramount to ensuring the success and safety of such endeavours [1, 2]. In addition to the neuro-ophthalmic findings of spaceflight associated neuro-ocular syndrome (SANS), there are also effects on the anterior segment including increased risk for cataract and dry eye symptoms [3, 4]. Among the various ophthalmic systems affected by space travel, the cornea is an area of concern due to its sensitivity to environmental changes in microgravity and direct exposure to the space and spacecraft environment. In vivo studies of mice following spaceflight have shown corneal edema, epithelial thickening, and signs of DNA damage and increased apoptosis [5]. As the optical window to visual sensory information, optimizing human corneal health and minimizing risks is of utmost importance to vision and mission performance. This paper aims to explore the effects of spaceflight on the cornea, elucidating the physiological alterations, potential risks, and implications for future human space exploration endeavours.

Spaceflight, characterized by microgravity conditions, induces various physiological adaptations in the human body. SANS and increased risk of cataract development have been well documented [3]. Another finding that has been noted is that over 30% of astronauts on the International Space Station (ISS) have reported clinical symptoms of dry eyes, manifested as irritation or foreign body sensations [3], which may potentially be related to alterations in tear film dynamics and ocular surface characteristics. With the microgravity and radiation environment of spaceflight, these clinical findings highlight the need to further investigate the mechanisms underlying corneal changes in microgravity environments. Understanding the full spectrum of physiological changes in the cornea during spaceflight is essential for developing targeted interventions to mitigate their impact on astronaut visual function and ocular health.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA

    Joshua Ong

  2. Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA

    Benjamin Soares

  3. Texas A&M School of Medicine, Bryan, TX, USA

    Daniela Osteicoechea & Andrew G. Lee

  4. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA

    Cihan Mehmet Kadipasaoglu, Patricia Chévez-Barrios & Andrew G. Lee

  5. Department of Ophthalmology, University of Cambridge, Cambridge, UK

    Ethan Waisberg

  6. Tulane University School of Medicine, New Orleans, LA, USA

    Alex Suh

  7. Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA

    Ritu Sampige, Patricia Chévez-Barrios & Andrew G. Lee

  8. Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, New York, NY, USA

    Tuan Nguyen

  9. University College Dublin School of Medicine, Belfield, Dublin, Ireland

    Mouayad Masalkhi

  10. Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA

    Prithul Sarker, Nasif Zaman & Alireza Tavakkoli

  11. Vance Thompson Vision, Sioux Falls, SD, USA

    John Berdahl

  12. The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA

    Patricia Chévez-Barrios & Andrew G. Lee

  13. University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Patricia Chévez-Barrios & Andrew G. Lee

  14. Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA

    Andrew G. Lee

  15. Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA

    Andrew G. Lee

  16. Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA

    Andrew G. Lee

  17. Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA

    Andrew G. Lee

  18. Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Andrew G. Lee

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Correspondence to Joshua Ong.

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Competing interests

AGL, MD is on the Editorial Board for Eye and a consultant for the National Aeronautics and Space Administration (NASA) and is a consultant for Amgen (speakers’ bureau), Viridian, Alexion (speakers’ bureau), Stoke, Bristol Myers Squibb, and Astrazeneca.

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Ong, J., Soares, B., Osteicoechea, D. et al. The cornea during spaceflight: a frontier in space medicine ophthalmology. Eye (2024). https://doi.org/10.1038/s41433-024-03267-y

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