As the US population ages, and with the increasing prevalence of obesity and related chronic health problems that affect the eye, debilitating eye disease poses a substantial medical and cost concern. With early diagnosis and appropriate management, > 90% of severe vision loss may be prevented. Imaging modalities that excel at screening, early diagnosis, staging, and tracking treatment response, and can do so safely, quickly, and inexpensively are highly valued by ophthalmologists. Optical Coherence Tomography (OCT)-based technologies have revolutionized eye disease diagnosis, along with demonstrating clinical potential across a myriad of other areas – including cardiology, urology, dentistry, and more. However, high cost and complex assembly of current systems limit their widespread adoption and hamper their broad implementation. This project will develop next-generation OCT systems based on photonic integrated circuits (PICs) and custom-designed electronic integrated circuits (ICs). By leveraging the latest advances in the nanofabrication of photonic and electronic ICs, acquisition speeds 50 times faster than the current standard will be achieved alongside immense decreases in the OCT system footprint (i.e., readily employable at walk-in clinics) and unprecedented reductions in manufacturing cost that will facilitate community-wide accessibility. Pediatric patients will especially benefit from the shorter scan times. Altogether, by enhancing patient treatment and adherence to repetitive testing, PIC-OCT will substantially reduce vision loss and its medical and societal costs.