An Out-of-This-World Perspective on Residency from one of Forbes’ Thirty-Under-Thirty

Chances are no clinician reading this report has ever treated a patient with spaceflight associated neuroocular syndrome. Ophthalmology resident Joshua Ong, M.D., helped edit the textbook on it.

Raised in Columbus, Ohio, Dr. Ong’s introduction to space medicine was co-authoring a NASA grant to study the impact of space travel on human health as an undergraduate at The Ohio State University. It was there he conducted tissue engineering research into skeletal muscle loss in astronauts; research that was launched into space in 2019.

He has remained connected to space medicine ever since, through medical school at the University of Pittsburgh, to his PGY1 year in Internal Medicine at Michigan Medicine, and now his residency at Kellogg.

Ophthalmology and space medicine converge in the phenomenon known as spaceflight associated neuroocular syndrome (SANS), a condition observed only in astronauts who have undergone long-duration spaceflight. The clinical characteristics seen in SANS include optic disc edema, hyperopic refractive shift, posterior globe flattening, and choroidal folds. A serious occurrence in space travel, NASA considers SANS a significant barrier to future planetary space missions, such as traveling to Mars. Yet the pathophysiology and mechanisms surrounding SANS are not clearly understood.

In 2022, Dr. Ong served as associate editor of the first textbook on SANS, published by a global team of multidisciplinary experts. Dr. Ong also co-authored two chapters, including “An introduction to space medicine and the physiological effects of spaceflight on the human body.” The book is intended to serve as a reference for space medicine clinicians and researchers studying SANS to protect vision in astronauts.

“A condition unique to space travelers may seem like an niche topic of study,” notes Dr. Ong. “But as the range of science discussed in the book illustrates, SANS research may drive innovations to improve human health on Earth.”

Dr. Ong is collaborating on several of those innovations, including:

Visual assessment technology and machine learning —New low mass, low footprint technologies may help optimize the assessment of astronauts’ vision in real time in the austere environment of space. Those same advances might also help overcome barriers to screening and early intervention in underserved communities.

Wearable technology to address central vision distortion—Prolonged periods of microgravity may lead to macular disruption, diminishing central vision. Particularly on extended planetary missions, this could threaten astronaut safety and mission performance. Emerging head-mounted display technology can digitally suppress central visual distortion. This may prove a useful tool for improving vision in individuals on Earth with irreversible central vision loss from age-related macular degeneration.

For his work on the latter, Dr. Ong placed second at the 2022 NASA Human Research Program Investigators’ Workshop. He was also named one of Forbes’ “30 Under 30” in healthcare for his pioneering work.

Here at Kellogg, the focus of Dr. Ong’s residency is gaining experience in different ophthalmic subspecialties. But he is staying engaged in space medicine research. “I can’t imagine a more supportive environment for pursuing one’s own unique path in vision science then Kellogg.”

Header image caption: Joshua Ong, MD