Free COA® Study Guide: All 22 Exam Content Areas
An independent study guide for the IJCAHPO Certified Ophthalmic Assistant exam. Not affiliated with or endorsed by IJCAHPO.
The Certified Ophthalmic Assistant (COA) exam has 200 multiple-choice questions in 3 hours, drawn from 22 content areas. The areas are not weighted equally: History and Documentation alone is 9% of the exam, while several areas are 2%. Each guide below covers one area, listed heaviest first, so working from the top down puts your study time where the points are.
How to use these guides
- Start with the 5 heaviest areas. Together they make up 39% of the exam.
- After reading a guide, drill that area with practice questions by category.
- Take a free mock test to find your weak areas, then come back to those guides.
- Check yourself on any area with the free COA practice questions with answers, one or two from each content area.
- Not yet sure you qualify? See how to get COA certification: the eligibility pathways, applying, and renewal.
History and Documentation
9% of examChief complaint, history of present illness, ocular and medical history, medications and allergies, and accurate charting in the medical record.
General Medical Knowledge
8% of examOcular anatomy and physiology, systemic disease and the eye, ocular emergencies, and basic medical knowledge for the clinic.
Ophthalmic Patient Services and Education
8% of examPatient communication and education, assisting patients with special needs, and delivering clinical services professionally.
Visual Assessment
7% of examDistance and near acuity, pinhole testing, and acuity assessment across ages and abilities.
Pupil Assessment
7% of examPupil size, shape, and reactivity — direct and consensual response, swinging-flashlight test, and afferent pupillary defects.
Tonometry
7% of examIntraocular pressure measurement — applanation, rebound, and non-contact methods.
Pharmacology
6% of examDiagnostic and therapeutic medications, instillation technique, and side effects.
Visual Field Testing
6% of examConfrontation screening and automated perimetry — technique and artifacts.
Refractometry
5% of examRetinoscopy, subjective refinement, and refractometry technique.
Ophthalmic Imaging
5% of examOCT, fundus photography, and angiography — purpose and patient prep.
Medical Ethics, Legal, and Regulatory Issues
4% of examHIPAA and confidentiality, scope of practice, informed consent, and professional conduct.
Ocular Motility Testing
4% of examExtraocular muscles, cover testing, and cardinal positions of gaze.
Lensometry
3% of examNeutralizing spectacle prescriptions — sphere, cylinder, axis, add, and prism on the lensometer.
Biometry
3% of examAxial length measurement and IOL-calculation support — optical and ultrasound A-scan technique.
Supplemental Testing
3% of examColor vision, stereopsis, glare and contrast sensitivity, pachymetry, and other adjunct tests.
Surgical Assisting
3% of examMinor-procedure setup, aseptic technique, instruments, and assisting the surgeon in clinic and OR.
Keratometry
2% of examCorneal curvature measurement — mires, calibration, and readings for contact lenses and IOL calculations.
Diagnostic Ultrasound
2% of examA-scan and B-scan basics — indications, technique, and recognizing common echo patterns.
Microbiology
2% of examCommon ocular pathogens, specimen collection, hand hygiene, and instrument disinfection.
Optics and Spectacles
2% of examBasic optics, transposition, vertex distance, and spectacle lens forms and fitting concepts.
Contact Lenses
2% of examLens types and materials, insertion, removal, and care, and recognizing common complications.
Equipment Maintenance and Repair
2% of examSlit lamp, lensometer, keratometer — operation, calibration, and care.