Certified Ophthalmic Assistant (COA) Exam: Everything You Need to Know

Table of Contents

Why Get Certified?

Certification Requirements

Before Taking the Test

The Exam

Study Materials

Eye Tech Training's COA Exam Prep Study Course

* Up-to-date as of August 2018 * 


Hi there, my name is Sharon Alamalhodaei, COMT. I am the Lead Instructor of Eye Tech Training and I have been working in ophthalmology for twenty-five years. Whether you are looking for a new career in ophthalmology and are curious about levels of advancement, or you’re currently an ophthalmic assistant interested in ophthalmic assistant certification, here is all you need to know about becoming a Certified Ophthalmic Assistant (COA). This post covers the ins-and-outs of the COA exam, including information about the upcoming exam changes that went into effect on August 1, 2018.

You’ve probably heard about Eye Tech Training’s live and online COA exam prep courses, which include a COA study guide and a COA practice test. If you’re thinking about taking the exam, the Eye Tech Training certification course is a comprehensive resource to help you pass. Click on the image below to get started and keep reading to find anything you need to know about preparing for the COA exam and nailing it the first time!

Eye Tech training's coa exam prep course

First things first: the COA exam is administered by JCAHPO, the Joint Commission on Allied Health Personnel in Ophthalmology. According to their website, JCAHPO’s mission is “To promote global eye health and prevent blindness through training program accreditation, education and the certification of Allied Ophthalmic Personnel.” To this end, they provide a number of continuing education (CE) courses as well as different certifications depending on how long you’ve been working in the field and your skill level.

Why Get Certified?

There are many reasons to seek certification. But more importantly, there is no reason not to. If you are eligible to take the exam, you should do so. There are many reasons I feel this way. Most obviously, becoming certified as a COA distinguishes you from your peers. Taking the COA exam shows your doctor, your manager, and your colleagues that you take your vocation seriously. In general, this will have incredible benefits for your career and will help propel you to advancement.

Secondly, certified techs make more than non-certified techs. For many people, their salary increases along with their skill level. Exact salary amounts depends on many factors, including geographical location, years of experience, and whether you are in a management position, but the average base pay according to Glass Door is $30,000. Which means that there is plenty of room to advance. For example, after a year of working as a COA, you will be eligible to take the COT exam (Certified Ophthalmic Technician). This is an even more prestigious and exclusive title, and generally comes with another salary bump.

And finally, it is an incredibly rewarding personal challenge. When I decided to take the COA exam over twenty years ago, I did so because I wanted to prove to myself that I could do it. I showed myself that I am capable of being more than I ever expected. This gave me a vital confidence boost and undoubtedly helped bring me to where I am today.

Certification Requirements

There are a few different pathways you can take to become eligible for examination. For example, if you have graduated from an accredited clinical training program, there is no work experience requirement. Most people don’t go to an accredited program but get their training on the job, by applying for jobs in doctor’s offices and eye care clinics. If this applies to you, you must have a high school degree (or an equivalent), complete a JCAHPO-approved study course, and have been working under the supervision of an ophthalmologist for at least 1000 hours, which is about 6 months equivalent. Find more specific information from JCAHPO here. You can also contact them at 800-284-3937.

Before Taking the Test

Before taking the exam, you must submit your Application for Examination. This is something that everyone must do. In addition, you must pay $300. JCAHPO offers an option of taking a “practice exam,” wherein you pay $150 to sit for the exam. If you pass, you have thirty days within receiving your official results to pay the final $150 for your official COA Certificate. But remember, if you fail, there are no refunds. This is why it’s vital to make sure you are as prepared as possible going into the COA test. A little further down this article I include study tips.

If you do not pass the examination, you will be sent a retest application along with your results. For a short period of time after receiving the results, you can retest the COA exam for a discounted price.

The Exam

The exam tests your knowledge on nineteen separate core content areas. These core areas are then split into sub-content areas. You will be tested on these competencies by answering 200 questions. The exam takes three hours to complete in full. The core content areas are:


History Taking

  • Pupillary Assessment

  • Contact Lenses

  • Equipment Maintenance and Repair

  • Lensometry

  • Keratometry

  • Medical Ethics, Legal, and Regulatory Issues

  • Microbiology

  • Pharmacology

  • Ocular Motility

  • Assisting in Surgical Procedures

  • Ophthalmic Patient Services and Education

  • Ophthalmic Imaging

  • Refractometry

  • Spectacle Skills

  • Supplemental Skills

  • Tonometry

  • Visual Assessment

  • Visual Fields

Here is an example of some sub-content areas. Listed below are the sub-content areas for the core content area “Assisting in Surgical Procedures”:

  • Instrument Preparation

  • Refractive Surgery

  • Aseptic Technique

  • Non-refractive Laser Therapy

  • Intraocular Injections

  • Yag Laser

  • Sterilization

  • Surgical Site Identification

  • Laser Safety

The 2018 exam includes two new sub-content sections: Communications Skills and Administrative Duties. This information is found on page 15 on their PDF document “Certification and Recertification,” which is published by JCAHPO and is fully up-to-date. This is also where you will find the application to take the exam.

Study Materials

Feeling overwhelmed yet? So did I, when I was preparing for my COA exam back in 1993. But don’t panic - there are many resources available to help you.


JCAHPO lists a full list of study materials for the COA exam here. Most people cannot afford to buy as many books as are listed. The top two I would recommend:

  1. Ophthalmic Medical Assisting – An Independent Study Course by Emanuel Newmark, MD, FACS and Mary A. O’Hara, MD, FACS, FAAP, Fifth Edition, 2012, AAO, ISBN# 1615251537. Any edition newer than a 4th edition will do and they are readily available used on Amazon. Unless you have attended a formal accredited Ophthalmic Training Program, this book and the test you can purchases separately is a prerequisite for the COA exam - so you need it regardless.

  2. The Ophthalmic Assistant by H.A. Stein, R.M. Stein, and M. Freeman, Ninth Edition, 2012, C.V. Mosby Co., ISBN# 1455710695. Again, any recent edition will do and they are also readily available used on Amazon. The trick with this book is there is a TON of information in it that you don't need to know for the COA exam. So, refer to the test content areas and study just that content in this book.

Flash Cards

Many people also find flash cards to be helpful. It depends on your personal style of learning. The ATPO (Association of Technical Personnel in Ophthalmology) has produced a set for the COA exam which you can find here and which I recommend.

Get Social

Get a study buddy. It's much more fun joining forces with someone who is facing the same challenge you are. It holds you accountable for progressing with your studying and you can quiz one another.

Another great resource is social media, which definitely wasn’t around in the early 90s. It is so much more useful than playing Animal Farm and arguing with our relatives about politics (kidding). There are a few different Ophthalmic Technician Facebook groups that are very active and welcoming. If you decide to take my course, you will also get access to Eye Tech Training’s Facebook group “Eye Tech Training Student Study Group,” which is exclusively available to Eye Tech Training alumni. You can also follow the main Eye Tech Training Facebook page where I post study questions.

Eye Tech Training's COA Exam Prep Course

The most comprehensive resource available to you is the Eye Tech Training study prep course. Eye Tech Training offers both live and online COA exam prep courses. If we're not coming to your city anytime soon, you have the option of purchasing the online course. You’ll be in good company, amongst thousands of technicians that have taken the course and gone on to successfully pass their COA examination. This is a great option especially if you are a nervous test-taker or just need a little extra support!

Watch the video below for a FREE sneak peek into my online COA course. 

One of the biggest things that differentiates Eye Tech Training’s course from others is that there is ongoing support beyond the course, that you don't get with others - and this support is UNLIMITED. Click on the image below if you're ready to start studying!

Click here for more information about Eye Tech Training's COA Exam Prep Course and How to Buy

And finally, I have been in your shoes. I know how it feels to study for the exam. I know the anxiety and confusion, I know the pre-test jitters. I’ve coached thousands of students through the process and I am ready to help you through your journey too.