Applications of the ocular trauma score (OTS) as a framework for spaceflight related ocular trauma (SROT) triage and management

Spaceflight presents several unique challenges for the diagnosis and management of in-flight ocular trauma. Constrained medical resources, microgravity, and delayed access to advanced medical care require novel and unique approaches to ocular trauma. The Ocular Trauma Score (OTS), an evidence-based clinical tool, aids in establishing a prognosis for ocular injuries and offers a method of informed triage and management. As governmental space agencies and private space companies (e.g., SpaceX, Blue Origin, and Virgin Galactic) rapidly increase the number and length of human spaceflight missions, the development of increasingly autonomous medical decision-making will be critical for astronaut safety and mission success. This paper aims to evaluate the practical utility of the OTS during spaceflight and highlight potential protocols to optimize triage and management of spaceflight related ocular trauma (SROT) effectively during future missions.