This study investigates ocular complaints and diagnoses in spaceflight, analyzing data from NASA's Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) for International Space Station (ISS) and Space Shuttle (STS) missions. The analysis included 135 STS missions (1981–2011) and 63 ISS missions (2000–2020), revealing that ocular events were reported in 83 STS and 41 ISS missions. The most common ocular complaints were eye irritation (33.1%), ocular foreign body or foreign body sensation (22.7%), dry eye syndromes (15.7%), and epiphora or excessive tearing (7.85%). Nine cases were classified as higher severity, including keratitis, corneal ulcer, chemical exposure, and corneal abrasion, but none required mission evacuation. Ocular symptoms varied by mission type and duration. On STS missions, common issues included eye irritation, dry eye syndromes, puffy eyes, eye burning, and eye pain. On ISS missions, common complaints were eye irritation and dry eye syndromes. Symptoms also varied by mission length, with eye irritation and burning sensation more common in shorter missions, while keratitis and eyelid lacerations were more frequent in longer missions. During extravehicular activities (EVA), 14 ocular complaints occurred, primarily due to particulates and antifog treatments. Common causes of ocular complaints included air particulates, sweat, irritants in spacesuits, and chemical exposure. Treatments included saline rinses, artificial tears, and antihistamines. However, the data lacked consistency in symptom descriptions and treatment details, limiting the ability to assess severity and effectiveness. The study highlights the need for a standardized classification system for ocular symptoms and diagnoses in spaceflight to improve diagnosis and treatment. It also emphasizes the importance of eye protection during EVAs and the potential use of preservative-free artificial tears to reduce ocular irritation. The study concludes that further research is needed to better understand and manage ocular conditions in spaceflight.This study investigates ocular complaints and diagnoses in spaceflight, analyzing data from NASA's Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) for International Space Station (ISS) and Space Shuttle (STS) missions. The analysis included 135 STS missions (1981–2011) and 63 ISS missions (2000–2020), revealing that ocular events were reported in 83 STS and 41 ISS missions. The most common ocular complaints were eye irritation (33.1%), ocular foreign body or foreign body sensation (22.7%), dry eye syndromes (15.7%), and epiphora or excessive tearing (7.85%). Nine cases were classified as higher severity, including keratitis, corneal ulcer, chemical exposure, and corneal abrasion, but none required mission evacuation. Ocular symptoms varied by mission type and duration. On STS missions, common issues included eye irritation, dry eye syndromes, puffy eyes, eye burning, and eye pain. On ISS missions, common complaints were eye irritation and dry eye syndromes. Symptoms also varied by mission length, with eye irritation and burning sensation more common in shorter missions, while keratitis and eyelid lacerations were more frequent in longer missions. During extravehicular activities (EVA), 14 ocular complaints occurred, primarily due to particulates and antifog treatments. Common causes of ocular complaints included air particulates, sweat, irritants in spacesuits, and chemical exposure. Treatments included saline rinses, artificial tears, and antihistamines. However, the data lacked consistency in symptom descriptions and treatment details, limiting the ability to assess severity and effectiveness. The study highlights the need for a standardized classification system for ocular symptoms and diagnoses in spaceflight to improve diagnosis and treatment. It also emphasizes the importance of eye protection during EVAs and the potential use of preservative-free artificial tears to reduce ocular irritation. The study concludes that further research is needed to better understand and manage ocular conditions in spaceflight.