COA case studies
COA · Put your knowledge to work in context.
The Certified Ophthalmic Assistant (COA) is an entry-level credential for allied health personnel working in ophthalmology practices, issued by the International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO). It is intended for ophthalmic assistants who perform routine patient care tasks under supervision and who want formal recognition of foundational competency. The exam samples broadly across the skills an assistant uses daily: clinical optics and basic ophthalmic optics, basic ocular anatomy and physiology, ocular pharmacology and medication instillation, patient history and visual acuity testing, patient preparation and assisting with procedures, and infection control, safety, and administrative duties. Preparation typically combines supervised clinical experience with structured review of each domain, prioritizing the highest-weighted areas (optics, anatomy, and history/acuity testing) while drilling medication instillation and instrument setup as hands-on skills. The COA case studies are 5 cases and about 1,990 words.
1Trial Lens Vertex Distance Change
A 34-year-old patient's manifest refraction is -8.50 -1.25 x 180 with a vertex distance of 12 mm. The patient selects a frame whose lenses will sit 7 mm from the cornea.
442 words, about 2 min2Pupil Dilation Before Fundus Exam in a Suspected Angle-Closure Patient
A 58-year-old woman presents for a routine diabetic eye exam. She mentions that 3 years ago she had a sudden painful red eye with blurred vision and halos, treated at an emergency department and now resolved.
347 words, about 2 min3Instilling Drops in a Patient with Poor Technique and a Contaminated Bottle
An 81-year-old patient with glaucoma is seen for a follow-up. He uses latanoprost nightly and timolol twice daily.
395 words, about 2 min4Visual Acuity That Does Not Match the Pinhole or the Symptoms
A 47-year-old office worker complains of gradual blur at distance in both eyes over about a year, worse at the end of the day. Unaided distance acuity is 20/40 right and 20/50 left.
362 words, about 2 min5Instrument Disinfection Between Patients with a Torn Contact Lens Case
You are assisting in a busy clinic. Between patients, you notice that the Goldmann tonometer prism was wiped with an alcohol swab and immediately reused on the next patient without drying.
444 words, about 2 min