Optical coherence tomography (OCT) is a technology invented in 1991 to image small critical tissue structures throughout the body with micrometer resolution. It is widely used in the management of eye and coronary heart diseases. In 2023, OCT received broad attention when its inventors received the prestigious Lasker-DeBakey Clinic Medical Research Award and the National Medal of Technology and Innovation from President Biden. For me, it was the culmination of 3 decades of work as an engineer, clinician, and translational researcher, as well as an even longer journey as an immigrant who tapped into the potential of America’s great research universities.

I will present OCT from an inventor’s perspective. The physical principles will be explained with illustrations on measuring the time-of-flight of light with interferometry. I will tell the story of the aha moment when the idea of OCT came to my mind, as well as the rapid pace of development that made OCT a clinical reality. The biggest applications of OCT in the management of eye diseases will be shown. Recent advances made at OHSU that enable OCT to advance beyond the imaging of tissue structure to the detection of blood flow and photoreceptor function will be described.

OCT is still a rapidly developing technology. The technical capabilities have improved in many aspects, but the most astounding has been the continual improvement in imaging speed, which has doubled approximately every 2.5 years over the past 3 decades. The technological advances have made more and more clinical applications feasible. I will present a vision for the broader applications of OCT, which includes imaging the eye to assess brain and cardiovascular diseases, as well as direct OCT imaging of other target organs such as the skin, digestive tract, brain, inner/middle ear, and teeth.