Distant stationary lights can be mistaken for stars or other aircraft
Cloud layers or even the northern lights can confuse a pilot and indicate a false visual horizon.
A black-hole approach occurs when the landing is made from over water or non-lighted terrain where the runway lights are the only source of light
Bright runway and approach lighting systems, especially where few lights illuminate the surrounding terrain, may create the illusion of being lower or having less distance to the runway
Spatial Disorientation, Motion Sickness and Inflight Illusions
Hypoxia, Hyperventilation, and Carbon Monoxide Poisoning
Hypoxia - Lack of oxygen to the tissues
Remedy by using supplemental O2
Hyperventiliation - Too little CO2 in the blood
Remedy by breathing into a bag, talking, or slowing breathing rate
Carbon Monoxide Poisoning - Susceptibility increases as altitude increases
Middle Ear and Sinus Problems
Stress, Fatigue, and Dehydration
Dark adaptation is impaired by exposure cabin pressure altitudes above 5,000 ft, carbon monoxide, deficiency of vitamin A, and by prolonged exposure to direct sunlight.