COA, COT, and COMT Certification

Certified allied health professionals who work for ophthalmologists are in demand. If you’re looking for a patient-centered healthcare career that doesn’t require a four-year degree, consider becoming a COA, COT or COMT. These trained, certified professionals assist ophthalmologists and work with patients to improve eye care.

What Is a COA, COT and COMT?

COA, COT and COMT refer to different levels of certified allied health professionals who work with ophthalmologists, or eye doctors. Allied health workers are trained to assist physicians and nurses to improve patient safety and outcomes. In ophthalmology, there are three levels of certification:

  • Certified ophthalmic assistant (COA). This is an entry-level position in ophthalmology. COA duties include collecting patient information, updating medical records, performing administrative office tasks, interacting with patients and educating patients about lenses, contacts and eye hygiene. COAs may also perform some vision testes, measure eye pressure and perform other minor eye examinations.

  • Certified ophthalmic technician (COT). A COT has more responsibilities than a COA. They explain procedures, tests and treatments to patients to help them prepare. They can perform more tests and take more technical measurements than entry-level assistants. A COT can also assist ophthalmologists during surgeries and prepare surgical equipment.

  • Certified ophthalmic medical technician (COMT). COMTs are certified to perform more technical and medical tests and measurements. These include diagnostic tests like ultrasounds and ophthalmic photography. They may conduct patient exams and administer medications under the supervision of an ophthalmologist. As the highest level of allied workers, COMTs may supervise COAs and COTs in an ophthalmology practice.

Allied ophthalmology health professionals mostly work in ophthalmology practices. They may also be hired by hospitals, community eye care facilities and vision care clinics.

The Joint Commission on Allied Health Personnel in Ophthalmology

To become an allied health worker in the field of ophthalmology, you will need to become certified through the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). States do not have licensing or certification requirements, but most ophthalmologists prefer to hire certified allied health workers.

The JCAHPO was created to improve eye health by regulating allied health professionals in the industry. It accredits training programs, standardizes skills and knowledge for workers, and provides certification and continuing education. The JCAHPO is an essential resource if you are considering working in ophthalmology as an allied health worker.

How to Become a COA

Ophthalmic assisting is considered an entry-level position. To become certified, you must take and pass the COA exam. Before you can take the COA test, you must show you are eligible. This means you have to complete a COA training program, which must be accredited by the International Council of Accreditation (ICA).

The requirements for COA certification also include a specific number of work hours depending on the level of certification:

  • COA-A1. There are no work experience requirements for this first level of certification.  
  • COA-A2. To qualify for the second level, you must have 500 hours of work experience supervised by an ophthalmologist. These must be within the 12 months before you submit the application for the exam.
  • COA-A3. For the third and final level of COA certification, you must have 1,000 hours of supervised work experience.

The COA exam cost is $300. Exam sections include imaging, corrective lenses, and interventions and procedures. The exam tests basic knowledge in these topics only. You must renew COA certification every three years. To renew, you must have 18 credits of continuing education. For all levels of certification, continuing education credits fall into two categories:

  • Group A credits – lectures, workshops, online courses and teaching courses
  • Group B credits – attending grand rounds and American Medical Association-approved courses, and authoring or co-authoring a scientific paper

Only 12 of the COA renewal credits can come from Group A. The remainder must be Group B credits.

How to Become a COT

The next level of certification is the technician credential. COT certification allows you to perform intermediate duties in your job as well as all the duties of an assistant. To earn certification, you must pass the COT exam. Eligibility for the COT test is based on the different levels of this certification:

  • COT-T1. For the first level, you need to complete a technician training program accredited by the ICA. You do not need to have any work experience.  
  • COT-T2. The second level requires COA certification and at least 2,000 work hours as a COA in the 24 months before applying for the exam. You must also submit 12 Group A continuing education credits.
  • COT-T3. For the third level, you must hold a certification as an orthoptist and have 2,000 hours of work experience in that role.
  • COT-T4. For the fourth level of COT certification, you must have a COA and 6,000 hours of work experience. These hours do not need to be certified. You also need 12 credits from Group A courses.

The COT exam covers the same topics as the COA exam but also includes an office and clinical skills portion. The knowledge tested is considered to be intermediate.

How to Become a COMT

A COMT is the highest level of certification for ophthalmic allied professionals. As a COMT, you will have expanded duties, more hands-on work with patients, and more technical and medical skills. There are five levels of COMT certification with eligibility requirements for taking the exam:

  • COMT-TG1. For the first level, there is no work experience requirement. You must have completed an accredited technologist level training program and at least two years of college courses.
  • COMT-TG2. For the second level, the education requirement is the same. You also must have 4,000 hours of supervised work experience from the previous two years.
  • COMT-TG3. To be eligible for level three, you must have COT certification, 12 Group A credits and 6,000 hours as a working COT.
  • COMT-TG4. Level four requires that you are a certified orthoptist, have 12 Group A credits and have 4,000 work hours as an orthoptist within the previous five years.
  • COMT-TG5. For the fifth level of COMT, you must have a COT certification, 12 group A credits, 3,000 hours of work as a COT and 6,000 hours of non-certified ophthalmology work experience.

Training Programs for Allied Ophthalmic Health Professionals

In order to qualify for certification exams through the JCAHPO, you must complete accredited academic training programs. These are not necessarily degree programs, but they need to be approved by the ICA to count. You can find programs at many community colleges, technical colleges and career or adult education centers.

The type of program you choose is important and will determine the level of credential you are eligible for upon completion. There are assistant programs for becoming a COA, technician programs for becoming a COT and technologist programs for becoming a COMT. You do not need to start with the COA level and work your way up to COT and COMT. You can start at any level as long as you enroll in the right program.

COA, COT and COMT certifications are important for maintaining standards in ophthalmology practices. These allied workers play a big role in assisting physicians and helping practices to run smoothly and safely. If you’re interested in working with patients and making a difference, consider one of these certification programs.