CERTIFIED OPHTHALMIC ASSISTANT (COA) LATEST TEST 150 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES 2026 LATEST EDITION
OVERVIEW
The COA exam assesses the knowledge and skills required for entry-level ophthalmic assisting,
focusing on eye anatomy and physiology, ocular diseases, patient care, clinical procedures,
and ophthalmic equipment use. Key areas include ocular anatomy and physiology, refractive
errors, common anterior and posterior segment disorders, diagnostic and imaging
techniques, visual acuity testing, tonometry, basic ophthalmic pharmacology, infection
control, and patient education. The exam emphasizes practical clinical application, testing
your ability to perform assessments, assist in procedures, interpret basic findings, and
communicate effectively with patients and the ophthalmic team. Understanding the rationale
behind procedures, normal vs abnormal findings, and safety standards is critical for success.
1. Which list correctly identifies the nine components of an ophthalmic history?
A. Chief complaint, medications, vitals, allergies, ROS, diagnosis
B. Chief complaint, present illness, past ocular history, ocular medications, general medical/surgical
history, systemic medications, allergies, social history, family history
C. Chief complaint, exam findings, diagnosis, treatment plan
D. Visual acuity, refraction, tonometry, slit lamp, fundoscopy
Correct Answer: B
Rationale: A complete ophthalmic history includes ocular, systemic, medication, social, and family
components.
2. Why is it important to ask patients specifically about medications they are taking?
A. To determine insurance coverage
B. To speed up the examination
C. Because certain medications may affect the eyes
D. Because medications replace diagnostic tests
Correct Answer: C
Rationale: Many systemic and ocular medications can cause ocular side effects.
3. What is the proper response when a patient asks an ophthalmic technician for medical advice or a
diagnosis?
A. Offer general advice
B. Provide educational materials
,C. Refer the patient to the ophthalmologist
D. Document and proceed
Correct Answer: C
Rationale: Technicians must not diagnose or provide medical advice.
4. What term is used for the reason a patient seeks medical care?
A. History of present illness
B. Review of systems
C. Chief complaint
D. Assessment
Correct Answer: C
Rationale: The chief complaint states why the patient is being seen.
5. Which elements are essential in social history taking?
A. Diet and exercise
B. Occupation and hobbies only
C. Smoking, alcohol, and drug use
D. Family medical conditions
Correct Answer: C
Rationale: These factors may influence ocular and systemic health.
6. Prior use of topical ocular medications is part of the patient’s:
A. Social history
B. General medical history
C. Past ocular history
D. Family history
Correct Answer: C
Rationale: Past ocular history includes prior eye treatments and medications.
7. Pertinent family history should include which relatives?
A. Children only
B. Parents, grandparents, and genetic siblings
C. Spouse and children
D. Distant relatives
,Correct Answer: B
Rationale: These relatives share genetic risk factors.
8. A patient reports hives after taking sulfa drugs. This information relates to:
A. Toxic reaction
B. Side effect
C. Allergic reaction
D. Overdose
Correct Answer: C
Rationale: Hives indicate a true allergic response.
9. Spasmodic, rhythmic dilation and contraction of the pupil is called:
A. Anisocoria
B. Mydriasis
C. Hippus
D. Miosis
Correct Answer: C
Rationale: Hippus describes rhythmic pupillary movement.
10. Which test is used to detect a relative afferent pupillary defect (RAPD)?
A. Cover test
B. Hirschberg test
C. Swinging flashlight test
D. Duochrome test
Correct Answer: C
Rationale: The swinging flashlight test evaluates optic nerve function.
11. Which iris muscle constricts the pupil in bright light?
A. Dilator
B. Ciliary
C. Sphincter
D. Levator
Correct Answer: C
Rationale: The sphincter pupillae causes constriction.
, 12. Pupil dilation is termed:
A. Miosis
B. Mydriasis
C. Anisocoria
D. Hippus
Correct Answer: B
Rationale: Mydriasis refers to dilation of the pupil.
13. Unequal pupil size is called:
A. Mydriasis
B. Hippus
C. Anisocoria
D. Amblyopia
Correct Answer: C
Rationale: Anisocoria describes unequal pupils.
14. Pupillometry refers to:
A. Measuring pupil reactions
B. Measuring pupillary diameter
C. Measuring accommodation
D. Measuring visual fields
Correct Answer: B
Rationale: Pupillometry quantifies pupil size.
15. When light is shined in one eye and both pupils constrict, this is the:
A. Direct response
B. Near response
C. Consensual pupillary reaction
D. Accommodation reflex
Correct Answer: C
Rationale: The opposite eye’s reaction is consensual.
16. Calibration of an applanation tonometer should be checked approximately every:
A. 6 months
B. 12 months
CORRECT ANSWERS WITH RATIONALES 2026 LATEST EDITION
OVERVIEW
The COA exam assesses the knowledge and skills required for entry-level ophthalmic assisting,
focusing on eye anatomy and physiology, ocular diseases, patient care, clinical procedures,
and ophthalmic equipment use. Key areas include ocular anatomy and physiology, refractive
errors, common anterior and posterior segment disorders, diagnostic and imaging
techniques, visual acuity testing, tonometry, basic ophthalmic pharmacology, infection
control, and patient education. The exam emphasizes practical clinical application, testing
your ability to perform assessments, assist in procedures, interpret basic findings, and
communicate effectively with patients and the ophthalmic team. Understanding the rationale
behind procedures, normal vs abnormal findings, and safety standards is critical for success.
1. Which list correctly identifies the nine components of an ophthalmic history?
A. Chief complaint, medications, vitals, allergies, ROS, diagnosis
B. Chief complaint, present illness, past ocular history, ocular medications, general medical/surgical
history, systemic medications, allergies, social history, family history
C. Chief complaint, exam findings, diagnosis, treatment plan
D. Visual acuity, refraction, tonometry, slit lamp, fundoscopy
Correct Answer: B
Rationale: A complete ophthalmic history includes ocular, systemic, medication, social, and family
components.
2. Why is it important to ask patients specifically about medications they are taking?
A. To determine insurance coverage
B. To speed up the examination
C. Because certain medications may affect the eyes
D. Because medications replace diagnostic tests
Correct Answer: C
Rationale: Many systemic and ocular medications can cause ocular side effects.
3. What is the proper response when a patient asks an ophthalmic technician for medical advice or a
diagnosis?
A. Offer general advice
B. Provide educational materials
,C. Refer the patient to the ophthalmologist
D. Document and proceed
Correct Answer: C
Rationale: Technicians must not diagnose or provide medical advice.
4. What term is used for the reason a patient seeks medical care?
A. History of present illness
B. Review of systems
C. Chief complaint
D. Assessment
Correct Answer: C
Rationale: The chief complaint states why the patient is being seen.
5. Which elements are essential in social history taking?
A. Diet and exercise
B. Occupation and hobbies only
C. Smoking, alcohol, and drug use
D. Family medical conditions
Correct Answer: C
Rationale: These factors may influence ocular and systemic health.
6. Prior use of topical ocular medications is part of the patient’s:
A. Social history
B. General medical history
C. Past ocular history
D. Family history
Correct Answer: C
Rationale: Past ocular history includes prior eye treatments and medications.
7. Pertinent family history should include which relatives?
A. Children only
B. Parents, grandparents, and genetic siblings
C. Spouse and children
D. Distant relatives
,Correct Answer: B
Rationale: These relatives share genetic risk factors.
8. A patient reports hives after taking sulfa drugs. This information relates to:
A. Toxic reaction
B. Side effect
C. Allergic reaction
D. Overdose
Correct Answer: C
Rationale: Hives indicate a true allergic response.
9. Spasmodic, rhythmic dilation and contraction of the pupil is called:
A. Anisocoria
B. Mydriasis
C. Hippus
D. Miosis
Correct Answer: C
Rationale: Hippus describes rhythmic pupillary movement.
10. Which test is used to detect a relative afferent pupillary defect (RAPD)?
A. Cover test
B. Hirschberg test
C. Swinging flashlight test
D. Duochrome test
Correct Answer: C
Rationale: The swinging flashlight test evaluates optic nerve function.
11. Which iris muscle constricts the pupil in bright light?
A. Dilator
B. Ciliary
C. Sphincter
D. Levator
Correct Answer: C
Rationale: The sphincter pupillae causes constriction.
, 12. Pupil dilation is termed:
A. Miosis
B. Mydriasis
C. Anisocoria
D. Hippus
Correct Answer: B
Rationale: Mydriasis refers to dilation of the pupil.
13. Unequal pupil size is called:
A. Mydriasis
B. Hippus
C. Anisocoria
D. Amblyopia
Correct Answer: C
Rationale: Anisocoria describes unequal pupils.
14. Pupillometry refers to:
A. Measuring pupil reactions
B. Measuring pupillary diameter
C. Measuring accommodation
D. Measuring visual fields
Correct Answer: B
Rationale: Pupillometry quantifies pupil size.
15. When light is shined in one eye and both pupils constrict, this is the:
A. Direct response
B. Near response
C. Consensual pupillary reaction
D. Accommodation reflex
Correct Answer: C
Rationale: The opposite eye’s reaction is consensual.
16. Calibration of an applanation tonometer should be checked approximately every:
A. 6 months
B. 12 months
