Systems and methods of real-time laser control and modulation for ophthalmic devices are described. The systems and methods can be used for precise laser delivery at sub-micron resolution in both laser treatment and scan imaging processes. In various embodiments, the systems can include a laser delivery device useful for surgical eye treatment, a laser delivery device useful for an ophthalmic scan imaging device, or both. In one embodiment, the system includes a laser surgery device integrated with a scan-based ophthalmic imaging apparatus. In such an embodiment, an eye motion signal obtained from the imaging apparatus can be used to provide fine-tuned control of the operation of the surgical laser beam in the laser surgery device.