Ocular trauma in microgravity: In-flight diagnostics and extraterrestrial strategies for management

Long-duration spaceflight missions (including the International Space Station [ISS]) are in one of the most remote and harsh environments humans live and work in. Medical emergencies in space are even more complicated in an already high-risk environment. Despite training, ISS crewmembers face many challenges in diagnosing and managing disease with limited diagnostic capability and equipment on the ISS, restricted medication availability, delayed access to medical professionals; and the latency of space missions. Ocular trauma (e.g., cabin contact with equipment, chemical exposure, and foreign body entry) has been well-documented in previous ISS missions, highlighting the vulnerability of crewmembers' vision. While no serious vision loss has yet occurred, the risk of ocular injuries during future commercial and lunar missions remains significant. We review the utilization of onboard diagnostic tools and potential management modalities with current ISS resources for mitigating long-term effects of ocular trauma in the unique microgravity environment of spaceflight. We aim to assess the overall medical preparedness for future space exploration to ensure the well-being and ocular health of crewmembers during extended missions to the Moon, Mars, and beyond.