Retinopathy of Prematurity (ROP) is a leading cause of childhood blindness in the United States. Optical Coherence Tomography (OCT) is a relatively new imaging technology capable of imaging ocular structures in cross section at high resolution. We present an age-customized approach to perform Spectral Domain OCT in neonates and infants, and from SDOCT, the in-vivo development of the human fovea during the premature period up through term birth along with retinal changes unique to premature infants with ROP. Finally, we explore how this novel information may affect our understanding of ROP and the possible implications in vision and retinal development.