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Ophthalmic Technician Duties

Melissa Flagg, COA, OSC, has worked in the medical field for over two decades as an ophthalmic technician and is certified by JCAHPO.

A Lensometer, also called a lensmeter

A Lensometer, also called a lensmeter

Ophthalmic Technician Job Description

Becoming an ophthalmic technician is a wonderful career choice. Formal education isn’t required, and with experience, an ophthalmic technician’s pay can be very lucrative.

Depending on the level of certification, a technician can make upwards of $50,000. I’ve known some technicians who have been in the field for over 30 years and were making $100,000 a year and up.

I have been an ophthalmic technician for the past 21 years, and I enjoy my career. What I enjoy the most is working under an ophthalmologist and the interaction with patients.

I learn something new about the eye or the body every day. Like all fields of medicine, it’s constantly changing and highly specialized.

Levels of Certification

There are three different levels of certification for an ophthalmic technician offered by JCAHPO (Joint Commission on Allied Health Personnel in Ophthalmology).

  • Certified Ophthalmic Assistant, or COA (entry-level)
  • Certified Ophthalmic Technician, or COT (intermediate level)
  • Certified Ophthalmic Medical Technologist, or COMT (top level)

Each level of certification has similar duties, but the higher levels have more advanced skill sets than the lower levels.

Ophthalmic Technician Duties by Certification Level

Certified Ophthalmic Assistants

As an entry-level position, COAs have basic duties. They can, however, take on more responsibility as they gain more experience. Some of their initial duties include:

  • Patient histories – taking the patient's complaint or history of injury/illness
  • Visual acuity testing – checking the patient’s vision
  • Lensometry – reading a patient's prescription from their glasses using a lensometer
  • Ocular motility testing – assessing the patient’s eye movements to determine if muscles are working properly
  • Confrontational visual field testing – a gross assessment of the patient’s peripheral vision
  • Pupil testing – checking the function of the pupil and determining its shape and size
  • Tonometry – checking the patient’s intraocular (eye) pressure
  • Giving dilating drops
  • Answering patient’s questions
  • Assisting the doctor with minor surgeries

COAs usually start at about $13.00 an hour depending on prior experience. If you’re just starting in the field and have no experience with ophthalmology whatsoever, you’ll most likely start somewhere around $8.00. Once you have had some training, and learn the basics of how to perform a basic exam, you should move up to about $10.00.

The Phoropter used to perform manifest refractions

The Phoropter used to perform manifest refractions

Certified Ophthalmic Technician

COTs have the same duties as COAs. However, they also have additional, more intricate duties that involve more education and training as well as more experience. Their additional duties include:

  • All of the duties of a COA
  • Manifest refraction – testing the patient for glasses using a phoropter
  • Retinoscopy – using a retinoscope to determine a patient’s glasses prescription (this is a highly specialized test that requires years of experience to master, and not all COTs can perform it accurately.)
  • Advanced ocular motility with prisms – testing patients with prisms to correct their double vision
  • Advanced testing – such as A-scans for cataract surgery, B-scans for retinal detachments, fluorescein angiography and fundus photography, and advanced clinical optics (such as prisms, the Maddox rod test, duochrome testing, etc.)

The advanced testing is what really makes the COT stand out. For example, the A-scan is an ultrasonic measurement of the length of the eye that allows the physician to choose the correct implant for cataract surgery. A B-scan is an ultrasound of the eye. A COT needs to be able to interpret what they see in the ultrasound in order to find a retinal detachment or other ocular abnormality.

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The Maddox rod test helps the technician find double vision, even if the patient can’t see it, and prescribe prisms to correct it. The duochrome test checks a final prescription to see if it is too strong for the patient to tolerate.

Ophthalmic photography is a fascinating area of ophthalmology. Fluorescein angiography is used to diagnose diseases such as macular degeneration or diabetic retinopathy. It involves injecting the patient with a yellow dye and taking pictures at specific intervals to find leaking blood vessels. Fundus photography involves taking pictures of the optic nerve and the macula as well as the peripheral retina.

COTs generally start at about $17.00 an hour. I know several COTs that make about $25 an hour or more. COTs also have the potential to move into management positions such as clinic supervisors or clinic directors.

The slit lamp

The slit lamp

Certified Ophthalmic Medical Technologist

COMTs are top-level technicians and are typically found in management roles such as clinic supervisors or directors. They are salary employees and start at about $50,000 a year. Their duties include those of the COA and COT, as well as the following:

  • Perform initial slit lamp biomicroscopy – diagnose any corneal or anterior chamber pathology (requires an in-depth understanding of the anatomy of the eye)
  • Maintenance of ophthalmic testing equipment and surgical instruments
  • Teaching other ophthalmic personnel
  • Supervising other ophthalmic personnel

A Rewarding Profession

COMTs have the most training of all the ophthalmic personnel. They are the doctor’s “go-to” person. COMTs with years of experience are able to diagnose some ocular pathology and help the doctor interpret the results of testing. They are an indispensable part of the ophthalmic community.

One of the main duties of all ophthalmic personnel, despite certification, is making the patient feel at ease and conducting a thorough examination. This can’t be taught, and I’ve met many technicians who have been “taught” how to work with patients, and none of their patients ever felt comfortable.

Experience is the only teacher when it comes to public relations. I found the easiest way to make a patient feel at ease is to be genuine and confident. Confidence only comes with experience and knowledge.

Becoming an ophthalmic technician can be challenging, but it is worth the effort. It’s a rewarding career with tangible results. If you enjoy working with people and can stomach some of the more disgusting aspects of ophthalmology, a career as an ophthalmic technician may be for you.

Further Reading

You may also enjoy reading my related article: How to Become an Ophthalmic Technician.

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2012 Mel Flagg COA OSC


Mel Flagg COA OSC (author) from Rural Central Florida on August 14, 2012:

Thank you so much Faith Reaper!

Faith Reaper from southern USA on August 14, 2012:

Very insightful hub. Great hub for someone undecided about what field they would like to go into. This is very well-written and detailed. Well done! In His Love, Faith Reaper

Mel Flagg COA OSC (author) from Rural Central Florida on August 14, 2012:

Thank you whowas, you're too kind!

Congrats on the quiz! lol Most people don't know the majority of the answers, so that's quite impressive! :D

Thanks so much for your kind compliments and votes!

whowas on August 14, 2012:

Another superb article that renders the whole subject fascinating - even to someone like me who has never considered such a career option!

The detail is amazing but the way you write makes it so easy to read and remember. That's quite a talent, you know. Voted this up without a second thought. Did all right on the quiz, too! :)

Mel Flagg COA OSC (author) from Rural Central Florida on August 14, 2012:

Thank you tillsontitan! I agree, there are so many fields out there; especially for those for whom college may not be an option. Not to mention you can make a decent living in these fields! College is important, but it's not for everyone, and for those people it's important to realize there are other options! :D

Thank you for your kind comment!

Mary Craig from New York on August 14, 2012:

This is the kind of hub that high school students need to read! There are so many interesting fields out there that students aren't aware of. You've explained this well from start to finish. Maybe you should write a book on careers and promote it to high schools! Not only is this informative but nicely written.

Voted up, useful, and interesting.

Mel Flagg COA OSC (author) from Rural Central Florida on August 13, 2012:

ha ha lol Thanks Doc! Did you take the quiz? I know it's kind of cheatin since you're a doctor and all... but.... :D

TahoeDoc from Lake Tahoe, California on August 13, 2012:

Great hub! This is definitely going to help anyone looking (pun :) ) to get into the field or anyone looking to understand the duties of technicians at various levels of certification.

Well organized, well-written and informative! UP & useful! Great job.

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