ABSTRACT Background The ocular surface is known to respond in certain ways in the aircraft environment, with subsequent symptomatic consequences for the individual. This has been found in several studies, which revealed symptoms of dry eye disease, while also demonstrating objective signs. Thus, with the increase in direct ultra long‐haul flights, there needs to be a further understanding of the impact of flying on the eye and specifically, the ocular surface. Purpose The aim of this review is to explore existing knowledge on the impact of the aircraft environment on the ocular surface, with the aim of guiding future advancements in this area. Methods Google Scholar, PubMed, and ScienceDirect electronic databases were used to identify studies conducted on the ocular surface in the aircraft environment. Terminology used for aircraft included “aeroplane,” “airplane,” “aircraft,” “flying,” “long flights,” and “flights,” and terminology used for ocular surface included “dry eye,” “ocular surface,” “ocular allergy,” and “environmental exposures.” Results Thirty studies were retrieved. It was found that the primary risk factors in the aircraft environment that affect the ocular surface include relative humidity, temperature, air velocity, atmospheric pressure, and air quality. Conclusions The aircraft environment affects the ocular surface in a number of ways, and strategies to mitigate these effects should be explored in future studies.
Mikhail et al. (2026) studied this question.