What is an Ophthalmic Assistant?

The field of eye care is a crucial part of the healthcare industry, as good vision helps us to perform the daily tasks of life and keep our independence and capacity, even when we may have problems with other aspects of our health. Ophthalmologists, fully-trained medical doctors who specialize in surgical and complex medical interventions, and doctors of optometry, who can diagnose and treat a wide variety of ocular conditions, are the stars of the show. But surrounding them is an essential supporting cast of highly trained allied health professionals.

Ophthalmic assistants are essential team members in any vision clinic. Specially trained to support ophthalmologists, they perform many of day-to-day tasks, such as taking patient histories, performing ocular measurements, and fitting glasses and contact lenses for patients.

They also perform many of the essential duties of practice management, whether that’s updating patient records, making sure the clinic is well-stocked with necessary supplies, answering phones or making sure the website is up to date.

Helping people get the most out of their vision is a necessary job that can be deeply moving—when someone who’s struggled to see for years gets the right kind of support for their vision, the result is immediate and hugely beneficial to their quality of life.

Fortunately, one can get involved in the field without spending years going to medical school. Ophthalmic assistants can be fully trained and ready to get good jobs in high-quality eye care facilities in as little as a year. Pay, benefits and working conditions for ophthalmic assistants are good, and the field is a growing one throughout the country.

Requirements for Becoming an Ophthalmic Assistant

Ophthalmic assistants are not regulated at a federal or state level, and some ophthalmic assistants are trained entirely on the job, but most employers will be looking to hire ophthalmic assistants who carry a professional certification from the Joint Commission on Allied Health Personnel in Ophthalmology, or JCAHPO.

There are several types of qualification offered by JCAHPO, most requiring different levels of work experience. All require completing training with a relevant clinical training program that has been accredited by the International Council of Accreditation for Allied Ophthalmic Education Programs (ICA).

Additionally, successful applicants need a high school or general equivalency diploma, and to be in reasonable health in order to perform work duties that may involve the operation of complex machinery and the moving and handling of heavy objects. As ophthalmic assistants work with sometimes vulnerable patients and handle sensitive data, some employers require a background check and pre-employment drug screens for successful applicants.

Certifications for Ophthalmic Assistants

The field of ophthalmic assisting includes people at a wide variety of skill levels, and the types of certification offered by JCAHPO reflect this.

Certified Ophthalmic Assistant

The JCAHPO Certified Ophthalmic Assistant (COA) qualification is the entry-level certification in the field. Designed to start eye care professionals on the path to success with a broad introduction to the field, the COA designation confirms the holder’s knowledge in 22 content areas ranging from taking patient histories to measuring the properties of the eyes to surgical assisting. The three-hour exam, administered at Pearson Vue testing centers, consists of 190 multiple-choice questions.

There are three levels of certified ophthalmic assistant certification. To be eligible for the first, COA-A1, you’ll need to have completed an ICA-accredited training program. The second, COA-A2, requires completion of an ICA-accredited training program and proof of 500 hours of work experience under the supervision of an ophthalmologist.

The third, COA-A3, is designed for those who have learned on the job—it requires having graduated from high school or a general equivalency diploma, plus the completion of an approved self-study program such as the JCAHPO Career Advancement Tool (JCAT) course or the American Academy of Ophthalmology Ophthalmic Medical Assisting course, and proof of 1,000 hours of ophthalmologist-supervised work experience.

The field of certified ophthalmic assisting is constantly developing, so for all three levels you’ll have a year to take the exam and certify after you’ve graduated from your training program. If more than a year has passed, for levels A1 and A2 you’ll need to submit 18 credits of coursework offered by the JCAHPO in the group A category for each year since your training program. For level A3, if more than 36 months have passed since completing your training course, you’ll need to submit 18 credits of JCAHPO Group A coursework for each subsequent year.

Certified Ophthalmic Technician

JCAHPO also classifies ophthalmic assistants at higher levels of skill, and has designed a program of career progression in the field. The Certified Ophthalmic Technician (COT) certification is aimed at certified ophthalmic assistants who wish to advance their careers by acquiring more technical depth within ophthalmic skill sets, such as in keratometry—the measure of the curvature of the cornea, which helps to determine the extent of vision disorders such as astigmatism, and the design of more complex types of glasses and contact lenses for patients.

As with COA certification, aspiring COTs will need to complete a three-hour multiple-choice exam at a testing center. They’ll also need to undergo a two-hour in-person skills evaluation with experienced clinical examiners.

There are four levels of COT certification, with level T1 designed for people going straight to COT from an accredited technician training program, and levels T2 and T3 aimed at people who take a training course and have at least 2,000 of experience as a certified ophthalmic assistant.

There is also a fast track, T4, for people who have at least 6,000 hours of non-certified experience working with an ophthalmologist. As with COA certification, those who have a significant time gap between their training and certification dates will need to complete additional accredited coursework.

Certified Ophthalmic Medical Technologist

The Certified Ophthalmic Medical Technologist (COMT) certification is aimed at individuals who have progressed through the COA and COT levels, as well as graduates who have undertaken a significant amount of specialized training. As well as all the skills of a COA and COT, the COMT examination and in-person professional performance test measure competency in some of the most advanced skills in ophthalmic assisting, such as teaching patients how to use devices for extreme low vision and administering complex diagnostic procedures.

To be eligible for COMT certification, you’ll need two years of college education and to have passed an accredited COMT training course. As with the other certification levels, qualification tracks are available for applicants with years of certified or non-certified experience in ophthalmic assisting.

For all JCAHPO certifications, the detailed handbook explains which competencies are tested and what weighting each competency receives on the exam. It also contains full details on each eligibility track and how to renew your certification.

Training Programs for Ophthalmic Assistants

The ICA maintains a comprehensive list of accredited programs across the United States and territories as well as in Canada. These programs involve both classroom education and valuable clinical and laboratory experience, working with real patients. Financial aid is often available at the state and federal levels.

It is important to remember that due to the clinical nature of the field, in-person programs will be necessary for eligibility for all certifications, unless one meets the quite significant work experience requirements for fast-track COA certification, as explained in the JCAHPO handbook. For those students, the self-study course offered by JCAHPO or the AAO course will satisfy training requirements.

Job Outlook and Salary Expectations

The Bureau of Labor Statistics reports an average salary of nearly $38,000 for ophthalmic technicians, with a range of around $13 to $27 per hour. The field is expected to grow by nearly 20 percent by 2030—much faster than average.

Certified ophthalmic assistants, technicians and medical technologists are found in doctor’s offices, eye clinics, hospitals, laboratories and outpatient care centers. Major metropolitan areas have both the highest concentration of jobs and the highest levels of pay for ophthalmic assistants.

Working as an Ophthalmic Assistant

Certified ophthalmic assistants can be found doing a great variety of tasks on a daily basis, from maintaining patient records and ordering supplies to assisting in delicate surgery. The work generally takes place during standard business hours, although hospital-based workers may need to come in at any time to assist ophthalmologists in urgent treatment or surgery.

Jobs are often advertised on major hiring websites like ZipRecruiter or Monster or are circulated through professional bodies like JCAHPO, and are also directly listed on the websites of eye clinics, commercial vision care centers and hospitals.