In this issue of JAMA Ophthalmology, Gustafson et al report on the association between neonatal retinal findings obtained with an investigational optical coherence tomography (OCT) device and neurodevelopmental outcomes at 2 years in infants enrolled in the BabySTEPS (Study of Eye Imaging in Preterm Infants) prospective study. Over the past decade, research into OCT use in the neonatal intensive care unit (NICU) for evaluating retinopathy of prematurity (ROP) has expanded. Multiple groups have used both commercially available and investigational OCT systems to better characterize structural and angiographic OCT findings in children with ROP. That work has shown promise both for using handheld OCT as a diagnostic tool for ROP and as a research tool to learn more about subclinical pathologic findings on OCT that were previously not easily identifiable on ophthalmoscopy. Previous work from Seely et al found an association between retinal structure on OCT and visual function at 9 months. The current study asks a similar but perhaps even more profound question: can retinal structure on OCT help us learn more about central nervous system function, particularly neurocognition?