Foveal hypoplasia is a rare disease that mostly occurs in association with other systemic or ocular diseases, such as albinism or aniridia. Diagnosis can be challenging, especially if foveal hypoplasia is an isolated finding. In recent years, optical coherence tomography (OCT) has been described as a useful tool to confirm the suspected diagnosis.1- 3However, the common asso ciation of nystagmus with foveal hypoplasia may generate artifacts in OCT scans and may lead to off-center scans and therefore unreliable results.1We examined 2 patients with foveal hypoplasia by using a simultaneous imaging device that combines a confocal scanning laser ophthalmoscope with a spectral domain OCT (Spectralis HRA+OCT; Heidelberg Engineering, Heidelberg, Germany). An integrated eye-tracking system ensures that the high-resolution OCT images are obtained at the exact retinal location that is selected on the stabilized fundus image. The principles of the Declaration of Helsinki were followed.