Non-mydriatic handheld optical coherence tomography for panretinal imaging

We present a handheld, non-mydriatic optical coherence tomography (OCT) system engineered for panretinal imaging across both pediatric and adult patients. The prototype achieves a 140° visual angle, enabling detailed visualization from the posterior pole to the peripheral retina without the need for pharmacologic dilation or scleral depression. A customized optical design minimizes beam wander while maintaining diffraction-limited resolution throughout the field of view. The system employs a 400 kHz VCSEL light source, facilitating high-speed image acquisition along with an extended axial imaging range of 12 mm in air, sufficient to accommodate retinal curvature. This combination of optical and hardware enhancements allows for rapid and comprehensive retinal assessment in a variety of clinical environments. To date, the system has been used in 117 imaging sessions involving broad patient cohorts, including 32 premature infants in a neonatal intensive care unit, as well as pediatric and adult patients in outpatient settings. In these sessions, the system has consistently produced high-resolution <i>en face</i> OCT images, B-scans, and OCT angiography (OCTA), demonstrating strong potential for diagnosing and monitoring peripheral retinal pathologies. The handheld, non-mydriatic design supports flexible use at the bedside and in preoperative settings, offering particular advantages in pediatric ophthalmology where conventional imaging techniques may be impractical.