An optical measurement instrument includes optical coherence tomography (OCT) interferometer and a pupil retro illumination system which directs laser light onto the retina of an eye via the sample arm of the OCT interferometer. The laser light passes through an intraocular lens (IOL) implanted into the eye, and an iris camera captures an image of the eye from a portion of the light returned from the retina of the eye, the returned light also passing through the IOL. One or more fiducials of the IOL are detected from the captured image, and an angular orientation of the eye is ascertained from the one or more detected fiducials.