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Special Communication
September 2017

Space Flight–Associated Neuro-ocular Syndrome

Author Affiliations
  • 1Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas
  • 2Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
  • 3Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, New York, New York
  • 4Department of Ophthalmology, University of Texas Medical Branch, Galveston
  • 5Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City
  • 6University of Texas MD Anderson Cancer Center, Houston
  • 7Colonel, US Army (retired), Cooper Landing, Alaska
  • 8Coastal Eye Associates, Webster, Texas
  • 9Space Flight–Associated Neuro-ocular Syndrome (SANS) Clinical Lead, Clinical Services, NASA Johnson Space Center, Houston, Texas
JAMA Ophthalmol. 2017;135(9):992-994. doi:10.1001/jamaophthalmol.2017.2396

New and unique physiologic and pathologic systemic and neuro-ocular responses have been documented in astronauts during and after long-duration space flight. Although the precise cause remains unknown, space flight–associated neuro-ocular syndrome (SANS) has been adopted as an appropriate descriptive term. The Space Medicine Operations Division of the US National Aeronautics and Space Administration (NASA) has documented the variable occurrence of SANS in astronauts returning from long-duration space flight on the International Space Station. These clinical findings have included unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and nerve fiber layer infarcts. The clinical findings of SANS have been correlated with structural changes on intraorbital and intracranial magnetic resonance imaging and in-flight and terrestrial ultrasonographic studies and ocular optical coherence tomography. Further study of SANS is ongoing for consideration of future manned missions to space, including a return trip to the moon or Mars.

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