Published in Non-Clinical

Certification Guide for Ophthalmic Technicians and Assistants

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8 min read

“So… are you a nurse? Are you studying to become a doctor? Did you go to school for this?” - The Typical Question to an Ophthalmic Technician

These are the standard questions I get on a daily basis from patients, and if you work in ophthalmology, I’m sure you do too.
I don’t blame them for being curious; ophthalmology is one of the few medical fields that requires almost a year of experience before you can even test for certification.
The levels of certification can be confusing, to the average person, they all sound roughly the same;
  • Assistant
  • Technician
  • Medical Technologist
Here are the differences between the various ophthalmic certifications:

Certified Ophthalmic Assistant (COA):

Becoming a COA is the first step in certification.
Most hospitals and medical groups will require that a technician has their COA, or sign paperwork saying they will obtain their COA within a year of employment.
Many optometric and ophthalmology private practice assistants defer becoming certified either because it is not a requirement of the job or they feel they know the skills. Therefore, the cost, both financially and sheer hours involved, of obtaining certification seems meaningless.
All certifications require you to recertify every three years, which consists of getting a doctor to recommend your certification, submitting Continuing Education Credits, and of course, paying JCAHPO a recertification fee.
By the way, The Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO), was established as a not-for-profit organization in 1969 to offer certification and continuing education opportunities to ophthalmic allied health personnel. Currently, more than 25,000 people in the U.S., Canada, and around the world hold a JCAHPO certification.
So then why Certify?
Despite the cost involved, anyone who has been practicing under an ophthalmologist for over a year should go through the steps to become certified.
Certified assistants make more money than non-certified (if this isn’t the case for you, please have a conversation with your office manager), and being able to prove you know your skills has value, both to your doctor and patients. Make your qualifications more than just, “I’ve been doing this a long time.”. People tend to like that.
A Certified Ophthalmic Assistant assist doctors in a variety of ways.
They take histories, evaluate chief complaints, administer ancillary tests, maintain equipment, and assist in minor procedures.
To pass the test, assistants will take a 200 question computerized multiple-choice test in which they will need to show a basic understanding of the anatomy of the eye and brain, basic pharmaceutical knowledge, and problem-solving skills.
Even assistants who have been working in ophthalmology for years should review the test format before taking the test, and do not rely on the advice of others in what the test includes, as there are multiple versions.
For example, when I took the test, I was told by multiple people that it was all about visual fields, really intense, in-depth requirements for understanding and interpreting. And maybe the test they got was, but mine was not. I was grossly underprepared (but I still passed!).

Certified Ophthalmic Technician (COT):

The next level in certification is a Certified Ophthalmic Technician.
The COT exam has two major parts, first, similar to the COA, there is a multiple choice exam consisting of 19 categories, after passing the exam, you then have up to 24 months to complete the skills portion of the certification.
Unlike the computerized exam, the Skills portion of the exam is hands-on, testing your knowledge of seven distinct categories. It’s daunting, but if you pass some, but fail others, you only need to retake the skills portions that you failed.
Acquiring your COT shows that you have an advanced knowledge of ophthalmic testing, and looks particularly good when applying for a job at a new office.
The majority of Certified Ophthalmic Assistants do not go on to become Certified Ophthalmic Technicians, but if you are looking at Ophthalmology as a career, then it is a surefire way to make yourself indispensable in any practice.

Certified Ophthalmic Medical Technologist (COMT):

Before I go into an explanation of what a Certified Ophthalmic Medical Technologist is, I feel it’s important to note that currently the test is only being administered at the JCAHPO headquarters in St. Paul, Minnesota. I am not entirely sure why, because it is a computer-based test, so, in theory, could be administered at any testing location.
Regardless of why they chose to keep the testing in St. Paul, the on-site testing lends itself to exclusivity and makes the COMT the most difficult to achieve for more reasons than just skill. Acquiring a COMT shows that you have the highest level of knowledge and dedication in your field.
Candidates for the COMT are required to have no less than three years working as a COT before taking the COMT Exam. The COMT exam is not it’s own exam, as much as it is a continuation of the COT exam I described earlier.
The additional portion of the exam is referred to as a Performance Test and consists of five sections. If you complete the Skills portion of the COT exam, they do not require you to repeat the for the COMT. Also similar to the COT exam, you are only required to retest on the areas of the Performance test that you failed.

Ophthalmic Surgical Assisting (OSA):

OSA is a sub-specialty that can be earned in conjunction with your certification. It is particularly useful for ophthalmic technicians who are most interested in assisting with in-office procedures and want to advertise their proven skills.
The OSA is a one-hour computerized exam consisting of 75 multiple choice questions, where technicians will be required to show their knowledge of instruments used during procedures, as well as the procedures themselves.
It is important to note that many ophthalmologists operate in hospitals, which require their surgical staff to, at a minimum, be a registered nurse, and so obtaining the OSA certification is most valuable for technicians who want to work in private practice.
The bottom line is to get certified.
Certified technicians certainly have a higher education level, and in my experience, tend to be much more dedicated the field of eyecare. The level of certification you strive for really depends on what you want to get out of your career.
There’s nothing wrong with obtaining the base-level COA certification and not pursuing beyond that level but it may limit how far you can go in ophthalmology. After all, some levels of certification take years to achieve, so if you’re new to the field, you have plenty of time to decide how far you want to go.

Let's chat more in the comments. Feel free to ask questions and I can expand on this article!

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