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The article explores the phenomenon of empty space myopia, which affects the visual acuity of pilots and astronauts when there are no specific objects to focus on in the sky. It discusses how this can lead to difficulties in detecting incoming objects and judging their size. The authors propose the use of extended reality auditory biofeedback as a potential solution to improve astronaut vision during long-duration spaceflight. The article encourages further research and development of technologies to enhance astronaut performance and safety in space. [Extracted from the article]

Ocular health is currently a major concern for astronauts on current and future long-duration spaceflight missions. Spaceflight-associated neuro-ocular syndrome (SANS) is a collection of ophthalmic and neurologic findings that is one potential physiologic barrier to interplanetary spaceflight. Since its initial report in 2011, our understanding of SANS has advanced considerably, with a primary focus on posterior ocular imaging including fundus photography and optical coherence tomography. However, there may be changes to the anterior segment that have not been identified. Additional concerns to ocular health in space include corneal damage and radiation-induced cataract formation. Given these concerns, precision anterior segment imaging of the eye would be a valuable addition to future long-duration spaceflights. The purpose of this paper is to review ultrasound biomicroscopy (UBM) and its potential as a noninvasive, efficient imaging modality for spaceflight. The analysis of UBM for spaceflight is not well defined in the literature, and such technology may help to provide further insights into the overall anatomical changes in the eye in microgravity. [ABSTRACT FROM AUTHOR]

Spaceflight associated neuro-ocular syndrome (SANS) is a unique phenomenon that has been observed in astronauts who have undergone long-duration spaceflight (LDSF). The syndrome is characterized by distinct imaging and clinical findings including optic disc edema, hyperopic refractive shift, posterior globe flattening, and choroidal folds. SANS serves a large barrier to planetary spaceflight such as a mission to Mars and has been noted by the National Aeronautics and Space Administration (NASA) as a high risk based on its likelihood to occur and its severity to human health and mission performance. While it is a large barrier to future spaceflight, the underlying etiology of SANS is not well understood. Current ophthalmic imaging onboard the International Space Station (ISS) has provided further insights into SANS. However, the spaceflight environment presents with unique challenges and limitations to further understand this microgravity-induced phenomenon. The advent of artificial intelligence (AI) has revolutionized the field of imaging in ophthalmology, particularly in detection and monitoring. In this manuscript, we describe the current hypothesized pathophysiology of SANS and the medical diagnostic limitations during spaceflight to further understand its pathogenesis. We then introduce and describe various AI frameworks that can be applied to ophthalmic imaging onboard the ISS to further understand SANS including supervised/unsupervised learning, generative adversarial networks, and transfer learning. We conclude by describing current research in this area to further understand SANS with the goal of enabling deeper insights into SANS and safer spaceflight for future missions. [ABSTRACT FROM AUTHOR]

Spaceflight associated neuro-ocular syndrome (SANS) is one of the potential barriers to human long-duration spaceflight (LDSF), including a manned mission to Mars. While a large barrier, the pathophysiology of SANS is not well understood, and functional and structural findings from SANS continue to be further characterized. Currently on the International Space Station (ISS), scheduled visual assessments are static visual acuity, Amsler grid, and a self-reported survey. Additional visual assessments may help the understanding of this neuro-ophthalmic phenomenon, as well as the effects of spaceflight of overall ocular health. In this paper, a case is made for expanding scheduled visual assessments to include dynamic visual, contrast sensitivity (CS), visual field testing, and virtual reality-based metamorphopsia assessment during spaceflight. These further assessments may play a key role in helping to determine the structural and functional changes associated with SANS, which are crucial to maintain astronaut vision during LDSF, as well as for developing countermeasures. Finally, a brief discussion is provided about current challenges to expanding visual testing during spaceflight and potential solutions to these barriers, specifically head-mounted visual assessment technology. [ABSTRACT FROM AUTHOR]

In anticipation of space exploration where astronauts are traveling away from Earth, and for longer durations with an increasing communication lag, artificial intelligence (AI) frameworks such as large language learning models (LLMs) that can be trained on Earth can provide real-time answers. This emerging technology may be helpful for acute medical emergencies, particularly in austere and distant space environments. In this manuscript, we provide an overview of generative pre-trained transformer (GPT) technology, a rapidly emerging AI technology, and implications, considerations, and limitations of such technology for space health. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Dynamic visual acuity (DVA) refers to the ability of the eye to discern detail in a moving object and plays an important role whenever rapid physical responses to environmental changes are required, such as while performing tasks onboard a space shuttle. A significant decrease in DVA has previously been noted after astronauts returned from long-duration spaceflight (0.75 eye chart lines, 24 h after returning from space). As part of a NASA-funded, head-mounted multimodal visual assessment system for monitoring vision changes in spaceflight, we elaborate upon the technical development and engineering of dynamic visual acuity assessments with virtual reality (VR) technology as the first step in assessing astronaut performance when undergoing G-transitional effects. We also report results from an early validation study comparing VR DVA assessment with traditional computer based DVA assessment. METHODS: Various VR/AR headsets have been utilized to implement DVA tests. These headsets include HTC Vive Pro Eye system. Epic’s game engine UnrealEngine 4 Version 4.24 was used to build the framework and SteamVR was used to experience virtual reality content. Eye tracking technology was used to maintain fixation of the participant. An early validation study with five participants was conducted comparing this technology versus traditional DVA with a laptop. RESULTS: T he head-mounted technology developed for assessing DVA changes during G-transitions is fully functional. The results from the early validation study demonstrated that the two DVA tests (laptop-based and VR) indicated a strong association between both methods (Pearson correlation coefficient of 0.91). A Bland-Altman plot was employed to assess levels of agreement, with all data points falling within the limits of agreement. DISCUSSION: T he results from this early validation study indicate that head-mounted DVA assessment performs similarly to traditional laptop-based methods and is a promising method for assessing DVA during spaceflight, particularly in G-transitions. Future studies are required for further assessment of validation and reliability of this technology. With its ease of use, accessibility, and portable design, VR DVA has the potential in the near-future to replace conventional methods of assessing DVA. The technology will likely be an important aspect to help monitor functionality and safety during interplanetary missions where astronauts are exposed to G-transitions. [ABSTRACT FROM AUTHOR]

During long-duration spaceflight, astronauts are exposed to various risks including spaceflight-associated neuroocular syndrome, which serves as a risk to astronaut vision and a potential physiological barrier to future spaceflight. When considering exploration missions that may expose astronauts to longer periods of microgravity, radiation exposure, and natural aging processes during spaceflight, more severe changes to functional vision may occur. The macula plays a critical role in central vision and disruptions to this key area in the eye may compromise functional vision and mission performance. In this article, we describe the development of a countermeasure technique to digitally suppress monocular central visual distortion with head-mounted display technology. We report early validation studies with this noninvasive countermeasure in individuals with simulated metamorphopsia. When worn by these individuals, this emerging wearable countermeasure technology has demonstrated a suppression of monocular visual distortion. We describe the considerations and further directions of this head-mounted technology for both astronauts and aging individuals on Earth. [ABSTRACT FROM AUTHOR]