COA Practice Test

COA Exam at a Glance

The COA exam is administered by JCAHPO and validates your knowledge across 22 weighted content areas of ophthalmic assisting. Passing this test is mandatory for earning the COA certification, which opens doors to higher pay and advanced roles in ophthalmology practices. Allied health professionals may also find our CNA practice test helpful for career development.

If you are searching for a COA exam practice test, start with the free questions on this page: every answer comes with an explanation, and regular COA test practice with the question sets below, plus the study notes, covers the COA exam topics in order.

Free COA - Certified Ophthalmic Assistant Study Tools

Interactive COA - Certified Ophthalmic Assistant resources on PracticeTestGeeks, free to start:

• Free COA Ophthalmic Knowledge and Diagnostic Questions and Answers — 11 questions with instant scoring and answer explanations
• COA - Certified Ophthalmic Assistant flashcards — review key terms and concepts card by card
• COA - Certified Ophthalmic Assistant study guide — topic-by-topic overview of what the exam covers
• COA - Certified Ophthalmic Assistant cheat sheet — one-page printable summary for last-minute review

According to International Joint Commission on Allied Health Personnel in Ophthalmology, “These results (pass/ fail) are considered unofficial and the candidate will not see their actual score.”^[3]

COA content outline and where to practise each area

The content areas below are copied from the official COA content outline published by International Joint Commission on Allied Health Personnel in Ophthalmology. The right-hand column shows which of our practice sets covers it.

Worked examples: how to reason through COA questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: What is the primary advantage of silicone hydrogel contact lenses over conventional hydrogel lenses?

1. They are less expensive to manufacture
2. They have significantly higher oxygen transmissibility (Dk/t)
3. They provide better UV protection
4. They require no cleaning or disinfection

Answer: B. They have significantly higher oxygen transmissibility (Dk/t)

Explanation:

The correct answer is that silicone hydrogel lenses have significantly higher oxygen transmissibility (Dk/t). The silicone in the material lets far more oxygen pass through to the cornea, which lowers the risk of hypoxia-related problems during wear.

The cost option is wrong because the material is not chosen for being cheap to make. The UV option is wrong because UV protection comes from a blocker added to a lens, not from the silicone itself. The option saying no cleaning or disinfection is needed is wrong because every lens that is reused still needs a care routine.

Rule to remember: when a question asks about the main advantage of a lens material, think oxygen delivery to the cornea first.

Example 2

Question: Which item is not designated as a version?

1. Levoversion
2. Sursumversion
3. Dextroversion
4. Intraversion

Answer: D. Intraversion

Explanation:

The answer is Intraversion, because it is not a recognized eye movement term. Versions are movements of both eyes together in the same direction. Levoversion is a shift to the left, dextroversion is a shift to the right, and sursumversion is an upward shift, so all of those are versions.

Our older note linked the prefix "intra-" to convergence. That is misleading. Convergence is a vergence, where the eyes move in opposite directions, and it has its own name. Intraversion is simply not a term in use.

Rule to remember: versions move the eyes the same way, vergences move them toward or away from each other, and you can read the direction from the prefix.

Example 3

Question: The state of pupillary contraction is known as:

1. Anisocoria
2. Miosis
3. Mydriasis
4. Photophobia

Answer: B. Miosis

Explanation:

The correct answer is Miosis, which means the pupil is constricted. The name describes the state of the pupil, not a disease.

Anisocoria is wrong because it means the pupils are unequal in size, and it says nothing about whether either one is small. Mydriasis is wrong because it is the opposite of miosis: a dilated pupil. Photophobia is wrong because it is light sensitivity, a symptom the patient reports, not a pupil state.

Rule to remember: pair each term with its opposite. Miosis is small and mydriasis is large. Anisocoria compares one pupil with the other. Photophobia describes how the patient feels in light.

How to use these practice tests

Start with the official content areas, because they tell you what the exam covers. Take one of our broader sets, such as the ophthalmic instruments set, without a timer and mark every area where you hesitate. Those areas become your study list.

Then work topic by topic. Do a short set on lensometry, tonometry, pharmacology or pupils, read the explanation for every question (including the ones you got right), and write the rule behind each miss in your own words. Return to the same set a few days later and see whether the rule holds.

Mix in history and documentation questions regularly. They are easy to neglect, and wording matters there.

Close to your test window, switch to longer mixed sets under the time limit so you get used to reading and answering at pace. Our questions are written by us for practice and are not real exam questions, so use them to find weak spots, not to predict your result.

Before you schedule, reread the official eligibility and fee pages. If you plan to test online, check the OnVUE requirements on the Pearson VUE page so equipment problems do not take up your eligibility period.

How to Use a COA Exam Practice Test the Way the Real Exam Is Scored

The real COA exam gives you 200 multiple-choice questions in 180 minutes, so a full-length COA exam practice test should be taken in one sitting with a timer set to 3 hours. That works out to 54 seconds per question; if you regularly need more than a minute, flag the item, move on, and return to it at the end rather than losing time you need for the heavily weighted sections.

Weight your COA test practice the way IJCAHPO weights the outline. Under the content outline in force since August 1, 2025, History and Documentation carries 9% of the exam, Ophthalmic Patient Services and Education and General Medical Knowledge 8% each, and Visual Assessment, Pupil Assessment and Tonometry 7% each. Those six areas together account for nearly half of your 200 questions, so they deserve the first and last review sessions. Areas weighted at 2%, such as Keratometry, Contact Lenses and Equipment Maintenance, still appear, but each contributes only about four questions.

IJCAHPO does not release a numeric score; you receive a pass/fail Performance Report broken down by content area. Mirror that on your own practice runs: record your percentage per topic, not just the overall total, and retest any area that sits below your average. IJCAHPO also sells an optional official COA Practice Examination for $150, which is worth taking once you are consistently scoring well on free question sets, because a passing result on it can be converted into certification for a further $150.

Budget for the $300 IJCAHPO exam fee for your initial COA certification, plus whatever you spend on study materials (the optional official COA Practice Examination is $150; free question sets on this page cost nothing). Many employers may reimburse these costs. Allied health professionals may also find our CNA practice test helpful for career development.

Ready to Pass Your COA Exam?

Join thousands of successful ophthalmic assistants who used our free practice tests to ace their JCAHPO certification. If you have been drilling a Quizlet COA practice test deck, add a timed COA exam practice test here to check pacing under real conditions. Start practicing now!

Ensure you earn your 18 IJCAHPO CE credits (at least 12 from IJCAHPO-approved courses) well before your cycle ends. AMA/CMA Category 1 CME is not accepted for COA renewal. Late renewal incurs an $85 late fee and, after the grace period, requires re-examination.

Pros and Cons at a Glance

Sample COA - Certified Ophthalmic Assistant Practice Questions

Try these questions from our free COA - Certified Ophthalmic Assistant practice tests. The correct answer and an explanation follow each question.

1. The Titmus stereo test (Stereo Fly Test) is used to evaluate a patient's depth perception. This test assesses which of the following visual functions?

   • A. Color perception
   • B. Contrast sensitivity
   • C. Stereopsis
   • D. Peripheral vision

Answer: C. Stereopsis

Stereopsis is the term for three-dimensional vision or depth perception, which is the ability to perceive the world in 3D and judge the distance of objects. The Titmus stereo test, which includes the well-known stereo fly, animal figures, and Wirt circles, uses polarized glasses to present slightly different images to each eye (binocular disparity) to measure a patient's level of stereopsis.

Answer: C. Esophoria

A phoria is a latent deviation that is only present when binocular vision is interrupted, such as by covering an eye. Since the eye was turned inward (eso-) under the cover and moves outward to fixate when uncovered, this indicates an esophoria. A tropia is a manifest deviation that is always present.

Answer: A. The test cannot be used to measure both vertical and horizontal photos at a distance and near.

Explanation: The Mallett unit (MA) is used to quantify the magnitude and direction of phorias in both vertical and horizontal planes at distance and near. Therefore, option A is incorrect; the test can be used to measure both vertical and horizontal phorias at a distance and near.

Answer: D. A right afferent pupillary defect (APD)

The swinging flashlight test is used to detect a relative afferent pupillary defect (RAPD or APD), also known as a Marcus Gunn pupil. This defect indicates a problem with the afferent pathway (optic nerve). When light is swung from the normal eye to the affected eye, the affected pupil receives a weaker signal to constrict and will paradoxically dilate.

Take the full COA - Certified Ophthalmic Assistant practice test

Official Resources

• IJCAHPO Certified Ophthalmic Assistant (COA) page explains the three eligibility pathways, the application process and the Pearson VUE scheduling steps.
• IJCAHPO COA exam content outline (PDF) lists all 22 weighted content areas and the skills tested under each.
• IJCAHPO recertification page covers the 36-month cycle, the 18 continuing education credits required for COA renewal and the retest-in-lieu-of-CE option.

Sources & last verified

1. International Joint Commission on Allied Health Personnel in Ophthalmology — number of questions, time limit, eligibility (official source). “Number of Exam Questions 200” Verified Oct 19, 2026 · source checked Oct 19, 2026.
2. jcahpo.co — exam fee, retake fee (official source). “$300.00 Initial (or over 12 months since initial examination)” Verified Oct 16, 2026 · source checked Oct 16, 2026.
3. International Joint Commission on Allied Health Personnel in Ophthalmology — passing score, exam fee, retake policy, score release (official source). “These results (pass/ fail) are considered unofficial and the candidate will not see their actual score.” Verified Oct 15, 2026.
4. International Joint Commission on Allied Health Personnel in Ophthalmology — validity (official source). “IJCAHPO certifications are valid for 36 months.” Verified Oct 19, 2026 · source checked Oct 19, 2026.
5. International Joint Commission on Allied Health Personnel in Ophthalmology — exam fee (official source). “Beginning August 1, 2021, the cost to recertify will change from $115 to $125.” Verified Oct 15, 2026.
6. pearsonvue.com — delivery (official source). “OnVUE online testing (Available for COA® and CRT exams only)” Verified Oct 20, 2026 · source checked Oct 20, 2026.
7. International Joint Commission on Allied Health Personnel in Ophthalmology — other (official source). “biometry” Verified Nov 1, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.