Hypoxia, Humidity and Low Temperature on In-flight Dry Eye

Abstract

Dry eye syndrome is a multifactorial disorder of the ocular surface that is increasingly reported among cabin crew and airline passengers. Typical aircraft cabin conditions such as low humidity, low temperature, and mild hypoxia contribute to disrupt the stability of the tear film and elevate the likelihood of ocular discomfort and inflammatory responses. To review the impact of cabin environmental conditions on the incidence and severity of dry eye symptoms in the aviation population and compare these findings with non-flying groups. This study is a systematic literature review of articles published within the last 10 years, retrieved from databases including PubMed, ScienceDirect, Google Scholar, Ingenta, and Frontiers. Keywords such as “dry eye,” “flight crew,” “air travel,” “cabin environment,” and “hypoxia” were used. Relevant studies were analyzed to evaluate the relationship between cabin exposure and dry eye symptoms. The incidence of dry eye syndrome was observed to be more pronounced among cabin crew (27.8%) and passengers (up to 20%) in contrast to office employees (13.9%). Cabin exposure was associated with accelerated tear evaporation, increased inflammation, and meibomian gland dysfunction. Recommended treatments include lipid-based artificial tears, topical antioxidants (vitamins A and E), cyclosporine A, and emerging biologic therapies. Preventive measures include adequate hydration, minimizing contact lens use, and using protective eyewear during flights. The aircraft cabin environment contributes prominently to the etiology and exacerbation of dry eye syndrome symptoms. A flight-specific preventive and therapeutic strategy is essential to preserve ocular comfort and health during air travel.

Keywords

• dry eyes syndromes
• aviation medicine
• air travel
• aviation
• altitude