IJCAHPO Core Examination Content Areas

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

HISTORY AND Ocular Ocular Ocular DOCUMENTATION Medical Medical Medical Medication Medication Medication Social Social Social Family Family Family

VISUAL Test and record visual acuity appropriately Test and record visual acuity appropriately Test and record visual acuity appropriately ASSESSMENT for patient with all levels of acuity: for patient with all levels of acuity: for patient with all levels of acuity: • Counting fingers • Counting fingers • Counting fingers • Hand motion • Hand motion • Hand motion • Light perception • Light perception • Light perception • No light perception • No light perceptionn • No light perception Test and record visual acuity on Test and record visual acuity on Test and record visual acuity on preliterate, illiterate, non-verbal, or preliterate, illiterate, non-verbal, or preliterate, illiterate, non-verbal, or foreign language patients foreign language patients foreign language patients Define low vision Define low vision Define low vision Test and record visual acuity using Test and record visual acuity using Test and record visual acuity using pinhole occlude pinhole occlude pinhole occlude Test and record stereoacuity Test and record stereoacuity Test and record stereoacuity Test and record near point of Test and record near point of Test and record near point of accommodation and convergence accommodation and convergence accommodation and convergence Test for visual acuity (distance and near) Test for visual acuity (distance and near) Test for accommodative convergence/ using optotype (Allen, Tumbling E, using optotype (Allen, Tumbling E, accommodation (AC/A) ratio numbers, and Snellen) numbers, and Snellen) Test for visual acuity (distance and near) Describe the advantages and Describe the advantages and using optotype (Allen, Tumbling E, disadvantages of different low disadvantages of different low numbers, and Snellen) vision devices vision devices Calculate approximate magnification needed to read a target acuity level Describe the advantages and disadvantages of different low vision devices Instruct patients in uses of low vision devices (optical and non-optical)

VISUAL FIELD Perform Amsler grid testing Perform Amsler grid testing Perform Amsler grid testing TESTING Perform confrontation fields testing Perform confrontation fields testing Perform confrontation fields testing Perform automated perimetry Perform automated perimetry Perform automated perimetry Perform Goldmann perimetry Perform Goldmann perimetery Perform Goldmann perimetery

PUPIL Measure Measure Measure ASSESSMENT Compare Compare Compare Evaluate Evaluate Evaluate Shape Shape Shape RAPD RAPD RAPD

TONOMETRY Measure intraocular pressure with Measure intraocular pressure with Measure intraocular pressure with hand-held applanator hand-held applanator hand-held applanator Measure intraocular pressure by Measure intraocular pressure by Measure intraocular pressure by applanation tonometry applanation tonometry applanation tonometry Measure intraocular pressure with Measure intraocular pressure with Measure intraocular pressure with non-contact tonometer non-contact tonometer non-contact tonometer Clean and disinfect tonometers Clean and disinfect tonometers Clean and disinfect tonometers

KERATOMETRY Perform automated keratometry Perform automated and Perform automated and manual keratometry manual keratometry

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

OCULAR Versions and Ductions Versions and Ductions Versions and Ductions MOTILITY Functions Functions Functions TESTING Anomalies Anomalies Anomalies Cover tests Near point convergence Near point convergence Stereoacuity Near point accommodation Near point accommodation Nystagmus Cover tests Fusional convergence amplitudes Strabismus with prisms Cover tests Worth 4-Dot test Strabismus with prisms Maddox rod Worth 4-Dot test Krimsky Maddox rod Stereoacuity Krimsky Nystagmus Stereoacuity Amblyopia therapy Nystagmus Convergence training Amblyopia therapy Convergence training

LENSOMETRY Neutralize Spectacles Neutralize Spectacles Neutralize Spectacles • Automated • Automated • Automated • Manual • Manual • Manual Fresnel Fresnel Ground-in prism Ground-in prism Slab-off Slab-off Geneva lens clock

REFRACTION, Measure refractive error with an Measure refractive error with an Measure refractive error with an RETINOSCOPY automated refractor automated refractor automated refractor AND REFINEMENT Use refraction techniques: fogging, Use refraction techniques: fogging, Perform and record retinoscopy results duo chrome, binocular balance duo chrome, binocular balance Refine refractive error (sphere and Measure vertex distance Perform and record retinoscopy cylinder) using phoropter or trial Perform and record transposition Measure vertex distance lenses in +/- cylinder Calculate and record Perform and record transposition Use refraction techniques: fogging, duo chrome, binocular balance spherical equivalence Calculate and record spherical equivalence Measure vertex distance Determine near add: Perform and record transposition • Bifocal Calculate and record spherical equivalence • Trifocal Determine near add: • Multifocals • Bifocal • Trifocal • Multifocals

BIOMETRY Diagnostic/standardized A-Scan Diagnostic/standardized A-Scan Diagnostic/standardized A-Scan and B-Scan and B-Scan

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

SUPPLEMENTAL Perform and record glare testing (e.g. BAT) Perform and record glare testing (e.g. BAT) Perform and record glare testing (e.g. BAT) TESTING Perform and record Potential Acuity Perform and record Potential Acuity Perform and record Potential Acuity Meter (PAM) Meter (PAM) Meter (PAM) Demonstrate use of slit lamp lenses Proper use of slit lamp Proper use of slit lamp Demonstrate use of pen light Demonstrate use of slit lamp lenses Demonstrate use of slit lamp lenses Perform and record color vision using Demonstrate use of pen light Demonstrate use of color plates Perform and record color vision using direct ophthalmoscopy Perform pachymetry color plates Demonstrate use of pen light Assess and record anterior chamber Perform pachymetry Perform and record color vision using depth with a slit lamp or pen light Measure and record fusional amplitudes color plates Perform and record laser tests for Perform and record Maddox Perform pachymetry glaucoma/retina (OCT) Rod measurements Assess and record anterior chamber Perform and record tear tests: Perform and record corneal depth with a slit lamp or pen light • Schirmer sensitivity testing Perform and record laser tests for • BUT glaucoma/retina (OCT) • Rose Bengal Identify fluorescein and indocyanine green angiography (ICG) phases Perform and record tear tests: Order and maintain patient education and images • Schirmer materials inventory Identify electrophysiologic tests: • BUT • ERG • Rose Bengal • VEP Perform and record contrast • EOG sensitivity testing Order and maintain patient education Assess and record head and materials inventory posture abnormalities Assess and record anterior chamber Perform and record specialized color tests: depth with a slit lamp or pen light • Farnsworth-Munsell D-15 Perform and record laser tests for • Farnsworth-Munsell 100-HUE glaucoma/retina (OCT) Perform and record exophthalmometry Perform and record tear tests: Perform and record wavefront diagnostics • Schirmer Measure and record fusional amplitudes • BUT Perform and record Maddox • Rose Bengal Rod measurements Perform and record corneal sensitivity testing Identify fluorescein and indocyanine green angiography (ICG) phases and images Identify electrophysiologic tests: • ERG • VEP • EOG Order and maintain patient education materials inventory

MICROBIOLOGY Describe and follow Universal Define the types of microorganisms: Define the types of microorganisms: Precautions and infection control bacterium, virus, fungus, protozoan bacterium, virus, fungus, protozoan measures to maintain clinical asepsis Explain pathways of disease transmission Explain pathways of disease transmission Assist in the collection of conjunctival Assist in the collection of conjunctival and corneal specimens and corneal specimens Describe and follow Universal Describe and follow Universal Precautions and infection control Precautions and infection control measures to maintain clinical asepsis measures to maintain clinical asepsis

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

PHARMACOLOGY Describe the advantages and Describe the advantages and Describe the advantages and disadvantages of various methods disadvantages of various methods disadvantages of various methods of drug delivery: drops, ointments, of drug delivery: drops, ointments, of drug delivery: drops, ointments, sustained-release, injectables, sustained-release, injectables, sustained-release, injectables, and systemics and systemics and systemics Describe the components of a Describe the components of a Describe the components of a medical prescription medical prescription medical prescription Describe and demonstrate the Describe and demonstrate the Describe and demonstrate the correct method of instilling drops correct method of instilling drops correct method of instilling drops and ointments and ointments and ointments Describe the indications, contraindications, Describe the indications, contraindications, Describe the indications, contraindications, and potential side effects of: and potential side effects of: and potential side effects of: • Mydriatics and cycloplegics • Mydriatics and cycloplegics • Mydriatics and cycloplegics • Provide patient instruction • Glaucoma medications • Glaucoma medications regarding medications • Anti-infective agents, anti-bacterial, • Anti-infective agents, anti-bacterial, anti-viral, anti-fungal, and anti-parasitic anti-viral, anti-fungal, and anti-parasitic • Allergy medications • Allergy medications • Steroids • Steroids • Non-steroidal, • Non-steroidal, anti-inflammatory drugs anti-inflammatory drugs • Ocular lubricants • Ocular lubricants • Anesthetics • Anesthetics • Diagnostic agents • Diagnostic agents • Nutritional supplements • Nutritional supplements • Anti-neovascular drugs • Anti-neovascular drugs • Provide patient instruction • Provide patient instruction regarding medications regarding medications

SURGICAL Instrument preparation Instrument preparation Instrument preparation ASSISTING Refractive surgery Refractive surgery Refractive surgery Aseptic technique Aseptic technique Aseptic technique Non-refractive laser therapy Non-refractive laser therapy Non-refractive laser therapy Intraocular injections Intraocular injections Intraocular injections Yag laser Yag laser Yag laser Sterilization Sterilization Sterilization Surgical site identification Surgical site identification Surgical site identification Maintain surgical instruments Maintain surgical instruments Maintain surgical instruments and equipment and equipment and equipment Laser safety Laser safety Laser safety

OPHTHALMIC Communicate effectively with: Communicate effectively with: Communicate effectively with: PATIENT • Co-workers • Co-workers • Co-workers SERVICES AND • Family of patients • Family of patients • Family of patients • Doctors • Doctors • Doctors EDUCATION • Patients • Patients • Patients • Vendors • Vendors • Vendors • Sales representatives • Sales representatives • Sales representatives Identify and provide care needs of Identify and provide care needs of Identify and provide care needs of diverse populations: diverse populations: diverse populations: • Cultural • Cultural • Cultural • Gender • Gender • Gender • Age • Age • Age Demonstrate effective interpersonal Demonstrate effective interpersonal Demonstrate effective interpersonal relationship skills relationship skills relationship skills Recognize and appropriately address Recognize and appropriately address Recognize and appropriately address patient dissatisfaction patient dissatisfaction patient dissatisfaction Instruct and educate patients on ocular/ Instruct and educate patients on ocular/ Instruct and educate patients on ocular/ systemic diseases, medications, tests, systemic diseases, medications, tests, systemic diseases, medications, tests, procedures, results, and treatments procedures, results, and treatments procedures, results, and treatments

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

OPHTHALMIC Counsel and provide patient education Counsel and provide patient education Counsel and provide patient education PATIENT on ophthalmic conditions, prevention, on ophthalmic conditions, prevention, on ophthalmic conditions, prevention, SERVICES AND compliance, and acceptance compliance, and acceptance compliance, and acceptance EDUCATION, Explain effects prior to administering Explain effects prior to administering Explain effects prior to administering Continued eye drops eye drops eye drops Demonstrate empathy for the patient Demonstrate empathy for the patient Demonstrate empathy for the patient Demonstrate how to properly Demonstrate how to properly Demonstrate how to properly greet people greet people greet people Assist patients and accompanying Assist patients and accompanying Assist patients and accompanying individuals with special needs (e.g. individuals with special needs (e.g. individuals with special needs (e.g. visually and hearing challenged) visually and hearing challenged) visually and hearing challenged) Provide patient referrals as appropriate Provide patient referrals as appropriate Provide patient referrals as appropriate Apply and remove eye dressing Apply and remove eye dressing Apply and remove eye dressing and shields and shields and shields Provide patient counseling Provide patient counseling Provide patient counseling and assistance for medication and assistance for medication and assistance for medication reimbursement programs reimbursement programs reimbursement programs Respond to and properly document Respond to and properly document Respond to and properly document phone calls phone calls phone calls Complete legal forms for patient benefits Complete legal forms for patient benefits Complete legal forms for patient benefits (motor vehicle, government, etc.) (motor vehicle, government, etc.) (motor vehicle, government, etc.) Make simple spectacle adjustments Make simple spectacle adjustments Make simple spectacle adjustments and repairs and repairs and repairs Schedule appointments based on Explain and care for ocular prosthetics, Explain and care for ocular prosthetics, degree of urgency contact lenses, spectacles, and contact lenses, spectacles, and Administer first aid for acute ophthalmic other devices other devices drug reactions and emergencies (e.g. Schedule appointments based on Schedule appointments based on chemical burns) degree of urgency degree of urgency Coordinate patient flow Administer first aid for acute ophthalmic Administer first aid for acute ophthalmic File, locate, and copy patient charts (scan drug reactions and emergencies (e.g. drug reactions and emergencies (e.g. if Electronic Medical Records (EMR)) chemical burns) chemical burns) Schedule non-ophthalmic medical Deliver patient prescriptions to Deliver patient prescriptions to diagnostic tests (e.g. magnetic a pharmacy via phone, fax, a pharmacy via phone, fax, resonance imaging [MRI], computed or electronically or electronically tomography [CT], blood tests) Coordinate patient flow Coordinate patient flow Vital Signs File, locate, and copy patient charts (scan File, locate, and copy patient charts (scan • Measure and record vital signs if Electronic Medical Records (EMR)) if Electronic Medical Records (EMR)) (e.g. blood pressure, pulse and Schedule non-ophthalmic medical Schedule non-ophthalmic medical respiration rate) diagnostic tests (e.g. magnetic diagnostic tests (e.g. magnetic • Perform cardiopulmonary resonance imaging [MRI], computed resonance imaging [MRI], computed resuscitation (CPR) procedures tomography [CT], blood tests) tomography [CT], blood tests) Vital Signs Vital Signs • Measure and record vital signs • Measure and record vital signs (e.g. blood pressure, pulse and (e.g. blood pressure, pulse and respiration rate) respiration rate) • Perform cardiopulmonary • Perform cardiopulmonary resuscitation (CPR) procedures resuscitation (CPR) procedures

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

GENERAL General Ocular Anatomy, Physiology General Ocular Anatomy, Physiology General Ocular Anatomy, Physiology MEDICAL Describe basic functions and processes Describe basic functions and processes Describe basic functions and processes KNOWLEDGE of each body system: of each body system: of each body system: • Respiratory • Respiratory • Respiratory • Cardiovascular • Cardiovascular • Cardiovascular • Endocrine • Endocrine • Endocrine • Nervous • Nervous • Nervous Describe the structure and function of Describe the structure and function of Describe the structure and function of the following: the following: the following: • Orbit • Orbit • Orbit • Extraocular muscles • Extraocular muscles • Extraocular muscles • Lids • Lids • Lids • Lacrimal system and tears • Lacrimal system and tears • Lacrimal system and tears • Conjunctiva • Conjunctiva • Conjunctiva • Cornea and sclera • Cornea and sclera • Cornea and sclera • Anterior chamber and angle • Anterior chamber and angle • Anterior chamber and angle • Aqueous humor • Aqueous humor • Aqueous humor • Lens • Lens • Lens • Uvea • Uvea • Uvea • Retina and vitreous • Retina and vitreous • Retina and vitreous • Optic nerve • Optic nerve • Optic nerve • Circulation of ocular blood supply • Circulation of ocular blood supply • Circulation of ocular blood supply • Visual pathway • Visual pathway • Visual pathway • Cranial nerves III, IV, V, VI, and VII • Cranial nerves III, IV, V, VI, and VII • Cranial nerves III, IV, V, VI, and VII • Describe the pathology of color vision • Describe the pathology of color vision • Describe the pathology of color vision Eye Diseases Eye Diseases Eye Diseases Differentiate between inflammation Differentiate between inflammation Differentiate between inflammation and infection and infection and infection Describe frequently encountered eye Describe frequently encountered eye Describe frequently encountered eye conditions involving: conditions involving: conditions involving: • Lids • Lids • Lids • Conjunctiva • Conjunctiva • Conjunctiva • Cornea • Cornea • Cornea • Lens • Lens • Lens • Uvea • Uvea • Uvea • Vitreous • Vitreous • Vitreous • Retina • Retina • Retina • Orbit • Orbit • Orbit • Trauma • Trauma • Trauma • Extra ocular muscles • Extra ocular muscles • Extra ocular muscles • Optic nerve • Optic nerve • Optic nerve • Cranial nerves III, IV, V, VI, and VII • Cranial nerves III, IV, V, VI, and VII • Cranial nerves III, IV, V, VI, and VII • Visual pathway • Visual pathway • Visual pathway Describe the ocular manifestations of the Describe the ocular manifestations of the Describe the ocular manifestations of the following systemic diseases: following systemic diseases: following systemic diseases: • Nutritional deficiencies • Nutritional deficiencies • Nutritional deficiencies • Diabetes mellitus • Diabetes mellitus • Diabetes mellitus • Thyroid disease • Thyroid disease • Thyroid disease • Autoimmune/inflammatory disease • Autoimmune/inflammatory disease • Autoimmune/inflammatory disease • Infectious disease • Infectious disease • Infectious disease (e.g. HIV/AIDS, tuberculosis) (e.g. HIV/AIDS, tuberculosis) (e.g. HIV/AIDS, tuberculosis) • Cardiovascular disease • Cardiovascular disease • Cardiovascular disease • Neurologic disorders • Neurologic disorders • Neurologic disorders • Cancer (primary and metastatic) • Cancer (primary and metastatic) • Cancer (primary and metastatic) Medical Terminology Medical Terminology Medical Terminology • Spell, define, and use medical • Spell, define, and use medical • Spell, define, and use medical terms correctly terms correctly terms correctly • Identify, acceptable abbreviations • Identify, acceptable abbreviations • Identify, acceptable abbreviations (specifically related to clinical practice) (specifically related to clinical practice) (specifically related to clinical practice) • Utilize a medical dictionary • Utilize a medical dictionary • Utilize a medical dictionary Safety Safety Safety • Define hazardous and • Define hazardous and • Define hazardous and bio-hazardous waste bio-hazardous waste bio-hazardous waste • Define acceptable methods for • Define acceptable methods for • Define acceptable methods for waste disposal waste disposal waste disposal

CONTENT AREAS COA (BASIC) COT (INTERMEDIATE) COMT (ADVANCED)

OPTICS AND Transpose cylinder readings Transpose cylinder readings Transpose cylinder readings SPECTACLES Prescriptions Prescriptions Vertex distance Vertex distance • Measure • Measure • Conversion • Conversion Geneva lens clock Progressive lens markings

CONTACT LENSES Contact lens types Contact lens types Contact lens types Contact lens care systems Wearing schedules Wearing schedules Need for follow-up appointments Contact lens care systems Contact lens care systems Need for follow-up appointments Need for follow-up appointments Contraindications, symptoms, and fitting Contraindications, symptoms, and fitting Perform contact lens fitting: Perform contact lens fitting: • Soft rigid • Soft rigid • Toric • Toric • Bifocal • Bifocal Specialty lenses for: • Irregular cornea • Post-transplant • Keratoconus • Cosmetic/prosthetics • Bandages

OPHTHALMIC Corneal topography Fluorescein angiography Fluorescein angiography IMAGING Scanning laser test for glaucoma/retina Corneal topography Corneal topography • HRT Scanning laser test for glaucoma/retina Scanning laser test for glaucoma/retina • OCT • HRT • HRT • OCT • OCT

PHOTOGRAPHY Slit lamp/anterior segment photography Slit lamp/anterior segment photography Slit lamp/anterior segment photography AND Fundus photography Fundus photography Fundus photography VIDEOGRAPHY External photography External photography External photography

EQUIPMENT Change batteries in Change batteries in Change batteries in MAINTENANCE ophthalmic instruments ophthalmic instruments ophthalmic instruments AND REPAIR Maintain and calibrate Maintain and calibrate Maintain and calibrate ophthalmic equipment per ophthalmic equipment per ophthalmic equipment per manufacturer’s recommendations manufacturer’s recommendations manufacturer’s recommendations Maintain emergency equipment Maintain emergency equipment Maintain emergency equipment Clean lenses and prisms Clean lenses and prisms Clean lenses and prisms Order and maintain medical supplies Order and maintain medical supplies Order and maintain medical supplies and inventories and inventories and inventories Maintain clinical equipment and supplies Maintain clinical equipment and supplies Maintain clinical equipment and supplies

MEDICAL ETHICS, Coding Coding Coding LEGAL AND Government/institutional rules Government/institutional rules Government/institutional rules REGULATORY and regulations and regulations and regulations ISSUES Quality assurance Quality assurance Quality assurance Ethical and legal standards Ethical and legal standards Ethical and legal standards Scribing Scribing Scribing Confidentiality Confidentiality Confidentiality Informed consent Informed consent Informed consent