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By Troy Bedinghaus, OD Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.

Optical coherence tomography works by using interferometry, which makes it possible to image tissue with near-infrared light rather than with gamma rays or ultrasound. Interferometry works by shining a beam of light into the eye, which is reflected by tissues at different depths. Images are built based on these reflections.

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Optical coherence tomography (OCT) is a noninvasive imaging technology used to obtain high-resolution cross-sectional images of the retina. OCT is similar to ultrasound testing, except that imaging is performed by measuring light rather than sound. OCT measures the retinal nerve fiber layer thickness in glaucoma and other diseases of the optic nerve.

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OCT images to approximately 2 to 3 millimeters below the surface of the tissue. Images are obtained clearly through a transparent window, such as the cornea. The light that is emitted into the eye is safe, so no damage will occur.

As a result, OCT not only provides much greater detail than other methods, but it also shows exactly which layer of the retina is accumulating fluid causing edema or swelling. OCT can also be used to track the healing or resolution of that swelling.

If your pupils are very small or if the doctor wants an image of a very specific area, your pupils may be dilated with medicated eye drops.

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Chopra R, Wagner SK, Keane PA. Optical coherence tomography in the 2020s—outside the eye clinic. Eye. 2021;35(1):236-243. doi:10.1038/s41433-020-01263-6

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The detail that can be visualized with an OCT is at such high resolution that doctors can see much finer details. The resolution of OCT is finer than 10 microns (10 millionths of a meter), which is better than MRI or ultrasound.

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Optical coherence tomography is a noninvasive imaging technology used to obtain high-resolution cross-sectional images of the retina. OCT obtains images by measuring light instead of sound. The test takes five to 10 minutes and can be used to evaluate many eye conditions.

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Aumann S, Donner S, Fischer J, Müller F. Optical coherence tomography (OCT): principle and technical realization. In: Bille JF, ed. High Resolution Imaging in Microscopy and Ophthalmology. Cham, Switzerland. Springer International Publishing; 2019:59-85. doi:10.1007/978-3-030-16638-0_3

Optical coherence tomography is a way for optometrists and ophthalmologists to image the back of the eye including the macula, optic nerve, retina, and choroid (a thin layer of tissue that is part of the middle layer of the wall of the eye).

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During an eye examination, optometrists and ophthalmologists can view the back of the eye and its anatomy. However, sometimes they need more detail or need to inspect details right below the surface, which is difficult to view with standard techniques. Some describe OCT as an “optical ultrasound” because it provides cross-sectional images.