The rapid development of optical coherence tomography (OCT) and its ophthalmic applications has resulted in the emergence of new laboratory and commercial systems that vary in performance and functionality. The introduction of high-speed imaging capabilities has abrogated the primary limitation of early OCT technology by providing in vivo three-dimensional volumetric reconstructions of both anterior and posterior segments of the human eye within reasonable time constraints. Currently, high-speed swept source OCT technology has made it possible to achieve OCT acquisition speeds of several million A-scans/s. Another direction of OCT development includes the introduction of adaptive optics to imaging of the posterior segment of the eye that allows correction of the eye's static and dynamic aberrations, resulting in the achievement of volumetric cellular resolution retinal imaging. In this review, we introduce readers to various aspects of the development of OCT technology within the context of its ophthalmic applications. We point out directions for future development and indicate different perspectives on this dynamically expanding method. We give a few examples of how OCT has been used over the past few years and describe how high-speed OCT imaging may be used in the future in clinical practice.