Spaceflight associated neuro-ocular syndrome: Proposed pathogenesis, terrestrial analogues, and emerging countermeasures

Joshua Ong, William Tarver, Tyson Brunstetter, Thomas Henry Mader, C. Robert Gibson, Sara S. Mason, Andrew Lee

Research output: Contribution to journalReview articlepeer-review

24 Scopus citations


Spaceflight associated neuro-ocular syndrome (SANS) refers to a distinct constellation of ocular, neurological and neuroimaging findings observed in astronauts during and following long duration spaceflight. These ocular findings, to include optic disc oedema, posterior globe flattening, chorioretinal folds and hyperopic shifts, were first described by NASA in 2011. SANS is a potential risk to astronaut health and will likely require mitigation prior to planetary travel with prolonged exposures to microgravity. While the exact pathogenesis of SANS is not completely understood, several hypotheses have been proposed to explain this neuro-ocular phenomenon. In this paper, we briefly discuss the current hypotheses and contributing factors underlying SANS pathophysiology as well as analogues used to study SANS on Earth. We also review emerging potential countermeasures for SANS including lower body negative pressure, nutritional supplementation and translaminar pressure gradient modulation. Ongoing investigation within these fields will likely be instrumental in preparing and protecting astronaut vision for future spaceflight missions including deep space exploration.

Original languageEnglish (US)
Pages (from-to)895-900
Number of pages6
JournalBritish Journal of Ophthalmology
Issue number7
StatePublished - Jul 1 2023


  • imaging
  • optic nerve
  • vision
  • Papilledema/diagnosis
  • Humans
  • Weightlessness/adverse effects
  • Astronauts
  • Space Flight

ASJC Scopus subject areas

  • Sensory Systems
  • Cellular and Molecular Neuroscience
  • Ophthalmology


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