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Free COA Practice Questions

10 free, exam-style IJCAHPO Certified Ophthalmic Assistant (COA) practice questions with answers and explanations. No signup required. Work through them below, then take the full free COA practice test to study every exam domain.

These 10 free COA questions are organized by exam domain, so you can see how each part of the IJCAHPO Certified Ophthalmic Assistant blueprint is tested. Reveal the answer and explanation under each question.

Domain 1: History and Documentation 9% of exam

Question 1

While documenting a visit, the technician records the patient's measured intraocular pressure. In a standard SOAP note, this measured value belongs in which component?

  1. Subjective - what the patient reports in their own words
  2. Objective - measurable findings obtained on examination
  3. Assessment - the provider's diagnostic impression
  4. Plan - the proposed treatment and follow-up
Show answer & explanation

Correct answer: B - Objective - measurable findings obtained on examination

Domain 2: Visual Assessment 7% of exam

Question 2

A patient is unable to turn the right eye outward (toward the temple). Which extraocular muscle, and its cranial nerve, is MOST likely affected?

  1. Medial rectus, innervated by cranial nerve III
  2. Superior oblique, innervated by cranial nerve IV
  3. Inferior oblique, innervated by cranial nerve III
  4. Lateral rectus, innervated by cranial nerve VI
Show answer & explanation

Correct answer: D - Lateral rectus, innervated by cranial nerve VI

Domain 4: Pupil Assessment 7% of exam

Question 3

A patient's distance acuity is recorded as 20/80 in the right eye. What does the number 80 represent?

  1. The distance, in feet, at which a normal eye reads that same line
  2. The percentage of normal central vision the patient still retains
  3. The smallest letter height the patient can resolve, in millimeters
  4. The number of optotypes the patient missed on that line of the chart
Show answer & explanation

Correct answer: A - The distance, in feet, at which a normal eye reads that same line

Domain 5: Tonometry 7% of exam

Question 4

During a swinging flashlight test, the technician notes that when the light is swung from the left eye to the right eye, the right pupil dilates rather than constricts. This finding indicates:

  1. A relative afferent pupillary defect (Marcus Gunn pupil) on the right side
  2. A normal direct and consensual pupillary light reflex in both eyes
  3. Simple physiologic anisocoria that is greater in dim illumination
  4. An efferent (third nerve) palsy affecting the left pupil's constriction
Show answer & explanation

Correct answer: A - A relative afferent pupillary defect (Marcus Gunn pupil) on the right side

Domain 6: Keratometry 2% of exam

Question 5

Before performing Goldmann applanation tonometry, the technician reviews the chart and learns the patient sustained a deep laceration to the eye earlier that day and may have an open globe. The MOST appropriate action is to:

  1. Instill additional topical anesthetic with fluorescein to improve the reading
  2. Defer tonometry and notify the ophthalmologist of the suspected open globe
  3. Switch to the non-contact air-puff tonometer to estimate the pressure
  4. Gently palpate the globe through the lid to approximate the pressure
Show answer & explanation

Correct answer: B - Defer tonometry and notify the ophthalmologist of the suspected open globe

Domain 8: Biometry 3% of exam

Question 6

A patient scheduled for dilation has a documented history of narrow (occludable) angles. Which class of drops is of GREATEST concern in this patient because it may precipitate an acute angle-closure attack?

  1. Topical aminoglycoside and fluoroquinolone antibiotic drops
  2. Topical beta-adrenergic blocking drops such as timolol maleate
  3. Mydriatic and cycloplegic dilating drops such as tropicamide
  4. Preservative-free topical lubricants and artificial tear drops
Show answer & explanation

Correct answer: C - Mydriatic and cycloplegic dilating drops such as tropicamide

Domain 11: Microbiology 2% of exam

Question 7

A patient asks the ophthalmic assistant, "Looking at my scans, do I have glaucoma?" Consistent with the assistant's scope of practice, the BEST response is to:

  1. Reassure the patient the scans appear normal so they will not worry before the visit
  2. Offer a preliminary interpretation, since the assistant personally performed the testing
  3. Explain that the ophthalmologist will review the results and discuss any diagnosis
  4. Decline to comment and move on to the next test without offering any explanation
Show answer & explanation

Correct answer: C - Explain that the ophthalmologist will review the results and discuss any diagnosis

Domain 13: Surgical Assisting 3% of exam

Question 8

A spectacle prescription is written as +2.00 -1.00 x 180. Correctly transposed into plus-cylinder form, the prescription is:

  1. +1.00 +1.00 x 090
  2. +3.00 +1.00 x 090
  3. +2.00 +1.00 x 180
  4. +1.00 -1.00 x 090
Show answer & explanation

Correct answer: A - +1.00 +1.00 x 090

Domain 19: General Medical Knowledge 8% of exam

Question 9

An instrument has been thoroughly cleaned and then treated with a high-level chemical disinfectant. Compared with sterilization, this process does NOT reliably accomplish which of the following?

  1. Removal of visible debris and organic material from the surface
  2. Destruction of most disease-causing bacteria and active viruses
  3. Destruction of all microbial life, including resistant bacterial spores
  4. Reduction of the overall microbial load present on the instrument
Show answer & explanation

Correct answer: C - Destruction of all microbial life, including resistant bacterial spores

Domain 20: Refraction 5% of exam

Question 10

A young patient is diagnosed with myopia. Which type of corrective lens focuses the image properly onto the retina?

  1. A minus-power (concave) lens, which diverges incoming light
  2. A plus-power (convex) lens, which converges incoming light
  3. A reading add placed in the lower portion of the lens
  4. A plano balance lens that carries no refractive power
Show answer & explanation

Correct answer: A - A minus-power (concave) lens, which diverges incoming light

The rest of the COA blueprint

The COA exam also covers these domains. Drill them in the full free practice test:

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