Long-term spaceflight induces multisystem stress, including cardiovascular deconditioning, skeletal muscle atrophy, immune suppression, and neuro-ocular syndromes. Current countermeasures reduce symptoms but cannot replicate the synergistic resilience needed for extended missions or critical illness. Hibernating animals, specifically brown bears (Ursus arctos), survive prolonged immobility, starvation, and bradycardia without resultant pathology. This review incorporates adaptations observed in bears and certain torpid species, including reversible insulin resistance, suppression of muscle atrophy genes MuRF1 and Atrogin-1, and maintenance of the heart despite seasonal production decline. The thirteen-lined ground squirrels (Ictidomys tridecemlineatus) maintain retinal structure and synaptic stability throughout torpor, avoiding neuro-ocular complications despite prolonged inactivity. Mechanisms span from RBM3-dependent synaptic maintenance, titin isoform remodeling under the control of RBM20, mTOR and FOXO pathway regulation, remodeled hydrogen sulfide metabolism, and microbiome-mediated nitrogen salvage. These adaptations are different from human adaptation to microgravity and disuse and offer translational candidates for synthetic torpor, probiotic engineering, neuroprotection, and protein-sparing therapy. Hibernators are not passive stress subjects; they perform coordinated anticipatory responses in multiple organs. Comparing these systems in large and small hibernators, we aim to uncover a biologically realistic path to human resilience. These findings guide a shift from reactive, pharmacological measures for preserving human health during space flight, intensive care, and extreme environments towards proactive, biologically initiated measures.

Neural vision restoration is a rapidly advancing discipline at the intersection of neuroscience, bioengineering, and ophthalmology. This review synthesizes emerging strategies to restore visual perception through retinal prostheses, optic nerve and thalamic implants, cortical brain-computer interfaces (BCIs), optogenetics, and non-invasive stimulation. Although initial experiments have demonstrated primitive visual abilities such as light perception and motion detection, artificial vision remains cognitively demanding and fundamentally different from natural vision. Advances in artificial intelligence and machine learning may enable adaptive, closed-loop systems that optimize stimulation, enhance low-light vision, and integrate environmental inputs for more intelligible percepts. At the same time, a growing understanding of neural plasticity, cortical remapping, and perceptual learning highlights the need for multidisciplinary strategies in visual rehabilitation. Ethical and regulatory concerns, including informed consent, data protection, neural enhancement, and equitable access, remain central to responsible implementation. The potential of BCIs to bypass the eye entirely, and of neuroprosthetics to be used in spaceflight, disaster response, or military medicine, expands the applications of vision restoration beyond blindness alone. Bridging technological, clinical, and ethical strategies in this review outlines the challenges and opportunities that define the future of neural ophthalmology. Ultimately, restoring sight will require not only functioning hardware, but systems compatible with the reorganized brain and the lived experience of visual loss.

Punctal occlusion is a common therapy for dry eye syndrome using permanent or biodegradable plugs to reduce tear drainage. This case describes a female in her 60s who developed left inferior canaliculitis 4 days after receiving biodegradable plugs. Surgical exploration removed one biodegradable plug and five retained silicone plugs, previously assumed to have extruded. Given that silicone plugs are a well-established risk factor for canaliculitis, the presence of multiple retained silicone plugs likely represents a significant predisposing factor. Although the acute timing of symptoms following biodegradable plug insertion suggests it may have served as a precipitating factor, causality cannot be established; its role should be interpreted within the context of the existing foreign material. The infection resolved with surgery and antibiotics. This case highlights the importance of confirming canalicular patency before inserting new plugs, as reliance on visual absence alone may overlook retained plugs and increase the risk of complications.

Ocular trauma represents a threat to crew safety and mission performance in space. Microgravity, confined environments, and exposure to particulate matter, chemicals, and mechanical hazards place astronauts at risk for corneal abrasions, open-globe injuries, chemical burns, lens dislocation, retinal detachment, orbital fractures, and barotrauma. Diagnostic capabilities during spaceflight remain limited by resources, lack of specialist expertise, and communication delays with Earth. Artificial intelligence, particularly convolutional neural networks and multimodal models, may help address these gaps through image interpretation, risk stratification, and longitudinal monitoring. Convolutional neural networks can extract hierarchical features from imaging data to identify subtle structural abnormalities, while multimodal models integrate imaging with clinical and environmental parameters to generate more comprehensive assessments. Terrestrial ophthalmology studies demonstrate the potential of these approaches across optical coherence tomography, ultrasound, fundus photography, and anterior-segment imaging. This review examines how these capabilities can be matched to ocular injuries during spaceflight, compares the suitability of different approaches across injury types, and identifies pathways toward autonomous care. Particular emphasis is given to spaceflight-related imaging and physiologic changes, constrained onboard hardware, and integration into workflows that support non-expert crew members. Collectively, these applications may expand diagnostic capabilities and enable earlier, more informed management during long-duration missions.