Assistant Level

Exam Study Guide

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Important new information (as of April. 2008).  The Joint Commission has changed course once again.  Instead of proceeding with a revised COA exam that was due to be released in August 2008, the new COA exam will not be released until August 2009, and the Joint Commission "expects the revised COA exam content to closely resemble the current certification examination." Therefore, it should now not matter much if you take the old version or the new version, and you have until August of 2009 to take the old version . 

Click on the hyperlink, or scroll down to see the sub-listings under each content area.   The study guide consists of comments and recommended reading for each of the content areas.  When you follow a link, a new window will open, so you will need to allow pop-ups on this site if you have a pop-up blocker.  Close the window when finished with the pop-up to return to this window.

There are references and hyperlinks in the study guide to four types of study materials. 

• Many references are to the book Ophthalmic Medical Assisting, which is the "homestudy" course published by the AAO.  You are required to complete this course in order to apply for the assistant level exam, so we assume that you have access to this book.  This book has recently been revised (third edition), but the second edition will be fine for study purposes.  Here is a study tip for you:  There are many references in the study guide to sections in Ophthalmic Medical Assisting.  Instead of looking up specific subjects, just read the whole book.
• Some hyperlinks go to sources on the web.  If one of these links gets broken for some reason, please e-mail me so that I can find a new source for the info.
• Many of the links go to the modules that are available for CE credit on this website.
• Some of the links go to PDF files of articles from the old Ophthalmic Trainer Newsletter, which some of you may remember.  These articles are not available for CE credit.

How much time will it take me to study for this exam?

I would figure about 10 hours for the Ophthalmic Medical Assisting book and an equal amount of time for the other reading.  Of course this does not count the time that you are nodding off in front of the TV with the book in your lap.

What about practice questions?

Practice questions get you acclimated to the testing environment and they help you study for the exam.  The eyetec.net modules that you will be studying have post-test questions associated with them.  Although, for obvious reasons, we cannot give you the answers to the post-tests, the answers come directly from the module content.  The Joint Commission website has books available with practice questions, and eyetec.net has practice tests available.

Content Areas

20%

17%

16%

15%

11%

21%

40

34

32

30

22

42

1. HISTORY TAKING

2. BASIC SKILLS AND LENSOMETRY

3. PATIENT SERVICES

4. BASIC TONOMETRY

5. INSTRUMENT MAINTENANCE

6. GENERAL MEDICAL KNOWLEDGE

1. HISTORY TAKING

Comments:  Read the chapter in Ophthalmic Medical Assisting on history taking.  Read the eyetec.net module on history taking.       

A. Presenting Complaint/History of Presenting Illness

1. Signs and symptoms

Comment:  A clinical sign is an objective observation of the patient's physical condition.  An example of a sign is a red eye.  A symptom is a subjective description from the patient that cannot be objectively verified.  A example of symptom is pain.

2. Triage

3. Refractive status

4. Injury

5. Contact lenses

6. Confidentiality

B. Past Ocular History

1. Refractive status problems

2. Injury

3. Diseases and prescriptions

4. Surgery and laser

5. Contact lenses

C. Family History

1. Diabetes

2. Glaucoma

3. Hypertension

4. Ocular diseases and dystrophies

5. Strabismus

6. Other

D. Systemic Illness, Past and Present

1. Hypertension

2. Diabetes

3. Cardiac problems

4. Pulmonary problems

5. Arthritis

6. Sickle Cell disease

7. Surgical procedures

8. Major infections

9. Other

E. Medications

1. Aspirin-containing medications

Comment: Here is a list of aspirin containing medications.  Common ones are Anacin, Bufferin, Ecotrin, Norgesic, and Percodan.

2. Diuretics

Comment: Common diuretics are Aldactone (spironolactone), Dyazide (triamterene), Hydrodiuril (hydrochlorothiazide), Lasix (furosemide), and Maxzide (triamterene).   Diuretics cause your body to loose water and are commonly used to treat high blood pressure.

3. Blood pressure medications

Comment:  Go to this page for a list of BP meds.

4. Birth control pills

Comment:  Here is a list of birth control meds.

5. Steroids

Comment:  Common oral steroids are prednisone, prednisolone, and methylprednisolone. 

6. Other

Comment:  Wow. "Other" covers a lot of territory.  Hopefully there won't be too many "other" questions.

F. Allergies and Drug Reactions

1. Penicillin

2. Sulfa

3. Local Anesthesia

4. Fluorescein

5. Other

G. Partially Sighted Patient

Comments:  Read the section in Ophthalmic Medical Assisting on the "Visually Impaired" (look this term up in the index)

1. Onset of visual loss

2. Use of low vision aids

3. Problems/goals

4. Home/family/community support

2. BASIC SKILLS AND LENSOMETRY       Top of Page

A. Method of Measuring/Recording Acuity

Comment:  Read the chapter in Ophthalmic Medical Assisting that covers vision testing.

1. Distance acuity

2. Near acuity

3. Children

4. Low vision

5. Illumination of target and background

6. Pinhole

7. Artifacts

8. Recording

B. Color Vision Testing

Comments:  Read the section in Module 23 about color vision testing.  Read the section in Ophthalmic Medical Assisting on the "Color vision tests" (look this term up in the index).

1. Color plates

2. D-15

3. Farnsworth-Munsell

4. Physiology

5. Children

C. Lensometry

Comments: You will need to know how to perform manual lensometry.  It is important that you actually learn the procedure on a real manual lensometer, and not rely on the descriptions in the book.  Doing so will make it much easier for you to answer questions about the procedure.  If you only use an auto-lensometer in your work situation, you may be able to find a manual lensometer in your optical shop or an outside optical shop that you are friendly with.  Read the section in Ophthalmic Medical Assisting on lensometry.

1. Sphere

2. Cylinder power/axis

3. Prism

Comment: Read Module 31 and Module 17

4. Multifocal power

5. Multifocal induced prism

Comment:  Read Module 18, Section 2

6. Base curve

Comment: Read Module 17, Section 2

7. Lensometer

8. Lens "clock"

Comment: Read Module 17, Section 2

9. Estimation with loose lenses

Comment: Read Module 16, Section 2

10. Aphakic lenses

11. Recording prescription

12. Transposition

Comment:  Read the section in Module 19 on transposition.

D. A-scan Biometry

Comment:  Read Module 1 and Module 2

E. Exophthalmometry

Comment:  Read the part in Module 29, Section 5.

F. Amsler Grid

Comment: Read the section on the Amsler Grid in Module 12, Section 3

G. Schirmer Tests

Comment:  Read this page.

H. Evaluation of Pupil

Comments:  Read Module 44.

I. Estimation of Anterior Chamber Depth

Comment:  Read Module 44.

3. PATIENT SERVICES         Top of Page

A. Ocular Dressings and Shields

Comment:  Read the sections in Ophthalmic Medical Assisting. Look up "dressings" in the index.

1. Indications

2. Proper use

B. Drug Delivery (Advantages/Disadvantages)

Comment:  Read this PDF article.

1. Drops

Comment:  Know your cap colors.  Dilating drops have red tops, beta blocker drops have yellow tops, alphagan has a purple top, prostaglandin drops have a teal colored top (e.g. Xalatan).

2. Ointments

3. Sustained release

4. Injections

5. Systemic

6. Complications

C. Spectacle Principles

Comment:  Read the chapter on "opticianry" in Ophthalmic Medical Assisting.

1. Interpupillary distance

Comment: Read Module17.

2. Frames

3. Multifocals

4. "Safety" lenses and frames

Comment: Read Module 18.

5. Adjustment and repair

6. Care of spectacles

7. Lens materials

Comment: Read Module 18.

D. Assisting Patients

Comments:  Read the chapters in Ophthalmic Medical Assisting on "Patients with Special Considerations" and "Minor Surgical Assisting".

1. Physically disables

2. Visually disabled

3. Pediatric/children

E. Minor Surgery

1. Assisting surgeon

2. Instructing patient

4. BASIC TONOMETRY        Top of Page

Comments:  As with all skill areas, it is important that you have experience performing Goldmann applanation tonometry.  Experience will make it much easier for you to answer exam questions.  Read the chapter on tonometry in  Ophthalmic Medical Assisting (Comprehensive Medical Eye Exam), and read the section on tonometry in Module 41.

A. Indentation

1. Principles

2. Errors

3. Cleaning and sterilizing

4. Advantages/disadvantages

5. Technique

B. Applanation

1. Principles

2. Errors

3. Cleaning and sterilizing

4. Advantages/disadvantages

5. Technique

C. Non-Contact

D. Complications/Contraindications

 

E. Scleral Rigidity

1. General concepts

2. Methods of assessing scleral rigidity

F. Factors Altering Intraocular Pressure

1. Squeezing eyelids

2. Heartbeat

3. Breath holding

4. Tight collar

5. Body position

6. Other

5. INSTRUMENT MAINTENANCE       Top of Page

Comments:  Familiarity with ophthalmic instruments is important to being able to answer the exam questions.  Know what each instrument is used for and know what it looks like.  If it has a bulb or a battery, know how to change the bulb or battery.  Read the chapter in Ophthalmic Medical Assisting on "Care of Ophthalmic Lenses and Instruments".

A. Acuity Projectors

B. Ophthalmoscopes

1. Direct

2. Indirect

C. Retinoscopes

D. Lensometers

E. Perimeters

F. Tangent Screen

G. Phoropters

H. Slit Lamps

I. Ultrasound

J. Keratometers

K. Lenses

L. Tonometers

M. Muscle Light

N. Special Instruments

O. Surgical Instruments

 

Comments:  Read the chapters in Ophthalmic Medical Assisting on "Anatomy and Physiology of the Eye", "Diseases and Disorders of the Eye", and "Optics and Refractive States of the Eye".

A. Cardiopulmonary Resuscitation

Comment:  You are no longer required to be CPR certified to be able to take the exams, but many offices require this for their medical personnel.  Read the CPR booklet that comes with a CPR course.  Read the chapter on "Patient Interaction, Screening, and Emergencies" in Ophthalmic Medical Assisting.

1. Fainting

2. Cardiac arrest

3. Acute drug reaction

 

Comment: The eyetec modules currently (as of 3-07) cover all areas of ocular anatomy and physiology, except for the external eye (lids, lacrimal, conjunctiva) and the orbit.

B. Anatomy

1. Cardiovascular

Module 9 -  General Medical Knowledge - Part 2

2. Respiratory

Module 8 -  General Medical Knowledge - Part 1

3. Endocrine

Module 9 -  General Medical Knowledge - Part 2

4. Nervous

Module 8 -  General Medical Knowledge - Part 1

5. Ocular

Module 23 - The Posterior Segment, Part 1

Module 27 - Extraocular Muscle Anatomy and Physiology

Anterior segment: Module 43, Module 44, Module 45

C. Physiology

1. Cardiovascular

Module 9 -  General Medical Knowledge - Part 2

2. Respiratory

Module 8 -  General Medical Knowledge - Part 1

3. Endocrine

Module 9 -  General Medical Knowledge - Part 2

4. Nervous

Module 8 -  General Medical Knowledge - Part 1

5. Ocular

Module 23 - The Posterior Segment, Part 1

Module 27 - Extraocular Muscle Anatomy and Physiology

Anterior segment: Module 43, Module 44, Module 45

D. Systemic Diseases

1. Diabetes

Module 9 -  General Medical Knowledge - Part 2

2. Hypertension

Module 9 -  General Medical Knowledge - Part 2

3. Cancer

4. Atherosclerosis

Module 9 -  General Medical Knowledge - Part 2

5. Blood

6. Infections

7. Blood dycrasia

8. Infectious Diseases

Module 8 -  General Medical Knowledge - Part 1

Module 9 -  General Medical Knowledge - Part 2

E. Ocular Diseases

1. Refractive errors

Module 16 - Optics: Physical, Geometric, and Physiologic

Module 40 - Refractive Surgery

2. Infection

3. Injury

4. Red eye

Comment:  Read this PDF file.

5. Presbyopia

Module 4 - Accommodation and Near Vision

6. Other common disorders

Module 24 - The Posterior Segment, Part 2

Module 26 - Fluorescein Angiography, Part 2

Module 41 - Glaucoma, Part 1

Module 42 - Glaucoma, Part 2

Anterior Segment: Module 43, Module 44, Module 45

F. Ocular Emergencies

Comment:  Read this PDF file.  Read the chapter in Ophthalmic Medical Assisting on "Patient Interaction, Screening, and Emergencies".

1. First aid

2. Management in the absence of the physician

G. Metric Conversions

Comment:  Read this article.

H. Fundamentals of Microbial Control

Comment:  Read the chapter in Ophthalmic Medical Assisting on "Microbiology and Aseptic Technique".

1. Sanitation

2. Disinfection

3. Sterilization

4. Contamination