However, these handheld systems are associated with a steep learning curve for operation, are subject to motion artifacts and are still considerably heavy to hold or are attached to much larger systems that restrict use outside of the clinic. The portability of all these devices has allowed for imaging of patients in different positions and beyond the outpatient clinic, from intensive care to the surgical environment. A third device, the Heidelberg Spectralis Flex Module (Heidelberg Engineering, Heidelberg, Germany) incorporates a flexible ‘boom’ arm, which houses the acquisition lens and can be adjusted up to 100 cm from the main device body (Fig. Both systems benefit from rapid acquisition speed facilitating capture in paediatric populations. consists of a stand-mounted unit with a 2.2-kg removable scanner. The scanner consists of a 1.5 kg imaging probe connected to a console by a 1.3-m flexible cable with the most recent iteration, the C2300 additionally providing a variety of lenses to enable both anterior- and posterior-segment imaging. The Envisu C2300 OCT (Leica Microsystems, Germany) became the first handheld OCT scanner to receive clearance from the Food and Drug Administration. There are currently three commercial handheld SD-OCT systems available that address this issue. The construction of a portable, handheld, OCT device could increase the ease of access and expand OCT into settings where use is currently prohibited by its cost and size. In this review, we discuss several efforts that aim to address these limitations and thus improve the accessibility of this valuable diagnostic tool and enable point-of-care diagnostics, telemedicine and remote monitoring. A technician is often required to align the device, capture the image and perform a quality check to ensure that the image is acceptable. Third, a certain level of skill is required to capture optimal images. As patients are required to sit upright and stabilise their head on a chinrest whilst maintaining steady fixation, they are only suitable for ambulatory and cooperative patients. They are housed in large tabletop configurations and require alternating current power, constraining their portability. Second, the use of these devices are limited to typical clinical settings such as hospital clinics to optometry practices. First, they are costly the price of a retinal OCT device ranges from ~£30,000–£100,000. However, OCT machines have several limitations. Optical coherence tomography (OCT) imaging is rapid, safe, non-invasive and is increasingly being recognised as the gold standard for diagnosis of retinal disease. In this review, we discuss the major milestones in OCT hardware development to reach those beyond the eye clinic. In addition, advancing the portability of this technology to address opportunities in point-of-care diagnostics, telemedicine and remote monitoring may aid development of personalised medicine. Beyond high-income countries, there are 6.5 billion people with similar eye-care needs, which cannot be met by the current generation of bulky, expensive and complex OCT systems. However, more needs to be done to radically improve the access to OCT by addressing its limitations and enable penetration outside of typical clinical settings and into underserved populations. Remarkable progress has been made in the development of OCT technology to improve the speed of acquisition, the quality of images and into functional extensions of OCT such as OCT angiography. OCT systems have become ubiquitous in eye clinics but access beyond this is limited by their cost, size and the skill required to operate the devices. Optical coherence tomography (OCT) is a paragon of success in the translation of biophotonics science to clinical practice.
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