Optical coherence tomography (OCT) is a non-invasive imaging technique which can create optical tissue sections, enabling diagnosis of vocal cord tissue. To take full advantage from the non-contact imaging technique, OCT was adapted to an indirect laryngoscope to work on awake patients. Using OCT in a handheld diagnostic device the challenges of rapid working distance adjustment and tracking of axial motion arise. The optical focus of the endoscopic sample arm and the reference-arm length can be adjusted in a range of 40 mm to 90 mm. Automatic working distance adjustment is based on image analysis of OCT B-scans which identifies off depth images as well as position errors. The movable focal plane and reference plane are used to adjust working distance to match the sample depth and stabilise the sample in the desired axial position of the OCT scans. The autofocus adjusts the working distance within maximum 2.7 seconds for the maximum initial displacement of 40 mm. The amplitude of hand tremor during 60 s handheld scanning was reduced to 50 \% and it was shown that the image stabilisation keeps the position error below 0.5 mm. Fast automatic working distance adjustment is crucial to minimise the duration of the diagnostic procedure. The image stabilisation compensates relative axial movements during handheld scanning