Optical imaging and sensing modalities have been used in medical diagnosis for many years. An obvious example is endoscopy, which allows remote wide-field imaging of internal tissues using optical fibers and/or miniature charge-coupled device (CCD) cameras. While techniques such as endoscopy provide useful tools for clinicians, they do not typically allow a complete diagnosis to be made. Instead, physical biopsies may be required to confirm or refute the presence of disease. Furthermore, endoscopic procedures are both invasive and time-consuming. As such, much research is currently directed toward the development of devices that can provide a complete in vivo diagnosis without the requirement for a physical biopsy. Ideally, such devices should also be minimally or non-invasive, and they should provide immediate identification of disease at the point of care. Additionally, there is significant interest in the development of implantable diagnostic devices that can be left within patients’ bodies for extended periods of time (for several days or longer). Such systems could be used for automated disease diagnosis, and example applications include the detection of post-surgical infections as well as monitoring of the health status of patients undergoing chemotherapy. This chapter focuses on the development of optical instruments that can provide in situ diagnosis at the point of care, with an emphasis on progress towards miniature devices that may function as implants in the future.