New Frontiers in Space Medicine: Pupillometry for Astronaut Neuro-Ophthalmic Health

Introduction: Innovating for the Final Frontier

Space exploration pushes the boundaries of human endurance and technology. Among the unique medical challenges astronauts face is Spaceflight-Associated Neuro-ocular Syndrome (SANS)—a condition that threatens vision during and after long-duration missions. At Solvemed, we're tackling this head-on. Through our collaboration with the International Institute for Astronautical Sciences (IIAS), we're pioneering the use of AI-powered pupillometry to detect and manage SANS in space.

What is Spaceflight-Associated Neuro-ocular Syndrome (SANS)?

SANS refers to a set of ocular and neurological changes astronauts may develop after prolonged exposure to microgravity. Common symptoms include:

• Optic disc edema
• Globe flattening
• Choroidal folds
• Hyperopic (farsighted) shifts

Though the exact mechanisms remain under study, researchers suggest that fluid shifts and altered intracranial pressure in microgravity environments contribute significantly.

The Promise of AI Pupillometry

Quantitative pupillometry is a non-invasive, objective method of evaluating the pupillary light reflex (PLR) - a valuable biomarker for neurological and ocular function. This approach offers real-time, high-fidelity monitoring of eye health without the need for bulky equipment.

Collaboration with IIAS: Testing in Microgravity

In partnership with IIAS, Solvemed has conducted successful parabolic flight experiments, validating the feasibility of our AI Pupillometry System in both microgravity and hypergravity conditions (Figure 1.).

^{Figure 1. (A) Members of the research team rehearse during ground rehearsal in 1g the maneuvers necessary to manage the lighting conditions of the cabin, and stabilize both the recorder and the study subject to obtain a pupillometry reading using the AI Pupillometer mobile app. (B) The team obtaining pupillometric measurements during the microgravity portion of parabolic flight, while stabilizing themselves to optimize data capture, and shielding the study participant’s eye to minimize interference from changing ambient light.}

Key outcomes include:

• Stable data acquisition in microgravity
• Demonstrated usability by non-expert operators
• Confirmation of potential for in-flight astronaut monitoring

Why This Matters: Enhancing Astronaut Safety

Our work with IIAS underscores the growing need for smart, adaptable medical tools in space. As missions extend further into deep space, from lunar habitats to Mars expeditions, proactive health monitoring becomes mission-critical. Solvemed’s solution offers:

• Device independence across iPhone models
• Precision pupil metrics such as Pupil Reactivity (PuRe) score, constriction velocity, among others
• Actionable insights that empower astronauts and mission control
• Flexibility of testing, including in two-person (operator and subject) and one-person (i.e., self-testing) measurement setups (Figure 2.).
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^{Figure 2. Visualisation of an astronaut self-testing their pupil light reflex (PLR) with AI Pupillometry System. Feasibility of self-testing using the System was successfully demostrated as part of Solvemed's recent collaboration with the IIAS.}

Conclusion: A Shared Mission for Health in Space

At Solvemed, we’re redefining space medicine—starting with the eyes. Our partnership with IIAS marks a pivotal step in developing portable, AI-driven diagnostics for extreme environments. Together, we're ensuring that as humanity reaches for the stars, we can see the way clearly.