Low-cost optical coherence tomography (OCT) has shown promise in increasing access to noninvasive retinal imaging at the point of care, especially in low-resource environments. A next-generation low-cost OCT system is presented which improves performance over previous versions by employing balanced detection, improved spectrometer falloff, and an increased A-line rate of 40 kHz. An algorithm is presented for image display that uses a histogram matching procedure to improve contrast-to-noise ratio (CNR). Imaging performance is benchmarked with CNR analysis of retinal OCT images, demonstrating a CNR of 2.01 ± 0.39 (p <
0.0001) for macula images collected during a clinical trial, a significant improvement over previous low-cost OCT systems.