Space: A New Frontier in Eyecare

With each and every space-related discovery, there is potential for various terrestrial industries to benefit – whether in agriculture, transportation, or, in our case, healthcare.

Key examples of ophthalmology benefiting from such research include LADAR technology, which was originally built for spaceflight docking, but later used in LASIK. Similarly, the technology used to measure the mirrors in The James Webb Space Telescope were fine tuned ahead of application in LASIK technology.

But did you know that one of the largest barriers to astronaut health is an eye-centric condition, namely SANS (spaceflight associated neuro-ocular syndrome)? SANS represents a collection of neuro-ophthalmic findings observed in astronauts after long-duration spaceflight, including chorioretinal folds, posterior globe flattening, optic edema, and hyperopic refractive error shift.

In a previous article, we explored how this affliction stems from structural changes in the eyes, leading to temporary vision impairment (most likely) induced by a shift of bodily fluids towards the upper body and head. Today, it serves as one of the largest physiological risks to human health on a planetary mission.

More recently, a team of international researchers sought to further understand the nature of SANS, while supporting the development of novel technologies that can help overcome limitations both in the austere spaceflight environment and in ocular health on Earth (1).

“Ultimately, this condition’s underlying etiology is not well understood,” said Joshua Ong, ophthalmology resident physician at the University of Michigan Kellogg Eye Center. “Currently, the spaceflight environment is limited in the diagnostic methodologies available, thus, novel solutions must be deployed to ensure future safe travel.”

The parallels in barriers to ophthalmic healthcare delivery in underserved areas and the austere spaceflight environment (limited ophthalmic professionals, diagnostic imaging, and procedural care) have been closely analysed (2). Ong and his team now suggest the use of generative artificial intelligence (AI) and extended reality could reduce the burden of this issue. “AI certainly can help to further our understanding of SANS, but we mustn’t avoid the potential of different extended reality applications,” says Ong. “This includes the development of digital metamorphopsia suppression, which minimizes visual distortions in digital environments, as a countermeasure to prolonged spaceflight missions.”

The researchers identified that visual assessment technology and machine learning can also be applied to terrestrial ophthalmic diseases to help attenuate preventable and permanent blindness. Moreover, they also found that non-invasive fundus photos can provide useful angiographic images in settings where fluorescein angiography is not available – like the International Space Station.

As the prevalence of vision loss rises, leveraging every breakthrough at our disposal will be imperative – even if it means turning to the stars.