Patient Education This sections is the largest and most difficult section. I put this chapter first because it is good to get the largest section out of the way, but in reality the material in this chapter calls in material from chapters that come after it. You may have to jump around the a book a little to get the most out of this chapter. Surgery There are a lot of surgeries that patients have to have in ophthalmology.

When the doctor gets the patient in his room he should be able to understand the patients complaints in seconds. To do this the doctor needs a history that is complete, concise, and relevant. General History A history is obtained by asking specific questions. Try to condense the patient’s story to only include pertinent facts. You need to be like a detective and search for pertinent facts. Some people may be harder to get histories from than others.

Ocular Medicines (Instilling and Identifying) Eye drops are used in ophthalmology to: Dilate the pupil Numbing the eye Treat Bacterial infections Treat allergies Treat viral infections One disadvantage of eye drops is that they do not have long contact with the eye. If the eye requires prolong treatment then an ointment is prescribed. The problem with eye ointment is that it blurs the patients vision. Instilling Drops are instilled by:

Intraocular Lens Power Calculation When a surgeon performs cataract surgery he does not want to put in just any old lens. He needs to make an educated decision on what lens would cause the light to converge on the retina just right. To make this decision the physician needs the following information Refraction – The most current manifest refraction. Keratometry – The curvature of the eye A-constant – A constant that comes with the IOL Master Axial length – The distance between the anterior and posterior poles of the eye.

Slit-Lamp/Anterior Segment Photography The five types of slit-lamp illumination Illumination Meaning Direct Illumination is directly on area of interest Indirect Illumination is on another structure than the structure of interest Diffuse Illuminates entire area (nonspecific) Retroillumination Illuminates structure behind structure of interest Tangential Illuminates area across the surface of a structure Fundus Photography When taking a fundus photo the eye must be dilated and the lens clean.

Measure Measurements that help the optometrist properly fit contact lenses. Keratometry – This is a measure of the curvature of the eye using a keratometer. Iris Diameter – The diameter of the iris measured in millimeters. Refractive error – This is obtained by using the phoropter. Vertex Distance – This is the distance between the back surface of the glasses and the front of the cornea. Patient Instruction Instructions for patients using soft contact lenses include:

Amsler Grid Amsler Grids are just graph paper with a dot in the middle which the patient is supposed to focus on. Patients cover one eye while looking at the Amsler Grid. It is then the technicians job to ask questions about what they see. Amsler Grids are only used to test the central 20 degrees of a patients field of vision not the peripheral. If a patient is complaining of distortions it is important to use the Grid so that the patient can mark where distortions are seen.

Before reading this section I would recommend at least skimming Review of Ocular Diseases so that you are confident with common pathologies before you read about how those pathologies are treated surgically. General What is a minor procedure? A minor procedure is a simple procedure that can be perfumed with minimal risk. Many of these procedures are performed in the clinic. Examples of minor procedures are chalazion removal, punctal plug insertion, and foreign body removal.

Third-Party Coding Current procedural terminology (CPT) pronounced “captain” is how healthcare providers communicated their services to insurance companies. When collecting histories ask the eight questions required by CPT. The International Classification of Diseases (ICD) are diagnosis codes that allow all healthcare providers to communicate with each other. Government and Institutional Rules and Regulations The Health Insurance Portability and Accountability Act (HIPAA) – This act protects patients personal health information.

Visual Acuity Visual acuity is tested by asking the patient to read letters of different sizes. Visual acuity is broken into two pieces a numerator, the top number, and the denominator, the bottom number. The numerator represents the test distance. The denominator is the number that represents what the patient can see. For example: 20⁄20 Means that at 20 feet the patient can see what a normal eye can see at 20 feet.

First I highly recommend that you go through this tutorial. This is the best resource I have found on refraction. After you have gone through the plus and minus cylinder refraction tutorials read the rest of this post. Refractive Errors General Eye Shapes Emmetropia: This is a normal eye “well-proportioned” Myopia: This is nearsightedness. This is an eye that can see near objects well, but can’t see distant objects well.

Keratometry is the measure of the curvature of the cornea. Corneal Curvature The cornea has the most refractive power. Even for then the lens. The average thickness of the cornea is 0.5 mm(100 um). Corneal curvature is measured in millimeters/diopter. With the rule vs against the rule. With-the-rule astigmatism means that the strongest axis is the vertical axis (90 degrees) in plus cylinder which is the same as 180 degrees minus cylinder.

Before reading this section please brush up on spectacle skills to make sure that you know how to transpose. Automated Lensometry The automated lensometer is a lensometer that does all of the work for you. Just line of the lens then the machines beeps and spits out the reading. As long as you have selected the correct cylinder type you can’t really go wrong. Advantages to using the automated lensometer

Goldmann Applanation Tonometer The word applanate means to flatten. The purpose of applanation tonometry is to find ocular pressure. This follows the formaula Pressure = Force/Area. The applanation tonometer flattens a known area (3.06mm) with a given force to give pressure. Clean The Goldmann Applanation Tonometer may be cleaned by wiping with soap and water. While cleaning don’t bend the arm of the tonometer and make sure that the readings on the tonometer head are set to zero and level when finished.

Office Antisepsis Know the difference between these three words: Disinfection – inhibition of microorganisms Sterilization – destruction of microorganisms Sanitation – clean enough to be healthy Disinfection involves the destruction and inhibition of microorganisms on any surface. Germicides disinfect non-living surfaces, such as the counter tops in the clinic. Antiseptics disinfect living surfaces, such as you hands. I had a hard time trying to remember the difference between germicides and antiseptics.

Measure This section of the test is going to test your knowledge of pupil size. Two terms to know here are miotic and mydriatic. Miotic pupils are smaller than 2mm. Mydriatic is a pupil size larger than 6mm. Memorization Trick: Miotic is small like a tick. Mydriatic is big and dramatic. Compare Anisocoria is when the pupils are unequal sizes. This may happen after a traumatic incident. Know the difference between direct pupillary response and consensual pupillary response.

Introduction to muscles and muscle movements There are six muscles of the eye. Four of them are rectus muscles, meaning that they yank the eye straight back toward the origin of the muscle. These four muscles are either medial, near the nose, lateral, near the temple, superior, above the eye, inferior, below the eye. The other two muscles are oblique muscles which means that they pull the eye at an angle causing a slight toric motion.

This was a difficult section for me to study. I feel like the best way to get through this sections is to do some hard core memorization. I have included some tables. I know that a lot of times when I see a table in a book I just skip is, but treat this table like a check list of things to know. Make sure you can identified the instruments you are required to identify and know how to clean those instruments.

Pre Test Day When you pass your JCAT you will get an email which will lead you to a website to set up a time to take your test at a Person View Testing Center. Look up the directions to the testing center and get an estimate of how much time it will take you to get to the testing center. Also take into account traffic of you are traveling during rush hour.

What makes a prescription? If the eye were a perfect sphere then all we would need to correct vision would be a sphere lens. Though there are many people who can be corrected with a sphere lens many patients require a spherocylindrical lens because they have astigmatism. A spherocylindrical lens is made up of sphere power and cylinder power. Optometrists and ophthalmologists think of spherocylindrical lenses differently. Ophthalmologists think of adding the sphere and the cylinder.

  Outline General History Presenting Complaint Sign vs Symptom Double Vision Injuries to the eye Past Ocular History Past Medical History Medications Social History Family History   General History A history is obtained by asking specific questions. Try to condense the patient’s story to only include pertinent facts. You need to be like a detective and search for pertinent facts.

1. You don’t repeat material Repeat, Repeat, Repeat The more times you repeat something the longer you remember it. When I went through the Exam Review packets I would go through about 20 questions at a time then grade myself. If my score was an 80% or higher I would move on if not then I would repeat that set of questions. Why? If I was missing more than 80% of a set of questions that means that I really did not understand that set.

The COA will give you basic knowledge to help you become a more competent tech. You will find that as you study you will learn things that you never heard of before. I learned why a rose bengal drop was used and the differences between soft and hard contact lenses. You will learn something new and you will become more competent because of it. The COA will give future employers more confidence in hiring you

I created this 10 week study schedule that requires a little less than 1 hour a day. I chose to use my lunch hour because I wanted to focus on family at home. You will need the Certified Ophthalmic Assistant Exam Review ManualThere are five columns the first column represents the chapter from the Certified Ophthalmic Assistant Exam Review Manual. The second column is that name of the chapter. There third column represents the percentage of questions on the actual COA exam.

I wanted to lay out a few ways that you can become a COA. 1. 1,000 hours of work Experience + JCAT + COA Exam This is the most common way to become a COA. You have to work for an ophthalmologist for 1,000 hours (6 months full time) and pass the exam. You will also have to be sponsored by a doctor before you can set a test date.

Patient Education This sections is the largest and most difficult section. I put this chapter first because it is good to get the largest section out of the way, but in reality the material in this chapter calls in material from chapters that come after it. You may have to jump around the a book a little to get the most out of this chapter. Surgery There are a lot of surgeries that patients have to have in ophthalmology.

When the doctor gets the patient in his room he should be able to understand the patients complaints in seconds. To do this the doctor needs a history that is complete, concise, and relevant. General History A history is obtained by asking specific questions. Try to condense the patient’s story to only include pertinent facts. You need to be like a detective and search for pertinent facts. Some people may be harder to get histories from than others.

Ocular Medicines (Instilling and Identifying) Eye drops are used in ophthalmology to: Dilate the pupil Numbing the eye Treat Bacterial infections Treat allergies Treat viral infections One disadvantage of eye drops is that they do not have long contact with the eye. If the eye requires prolong treatment then an ointment is prescribed. The problem with eye ointment is that it blurs the patients vision. Instilling Drops are instilled by:

Intraocular Lens Power Calculation When a surgeon performs cataract surgery he does not want to put in just any old lens. He needs to make an educated decision on what lens would cause the light to converge on the retina just right. To make this decision the physician needs the following information Refraction – The most current manifest refraction. Keratometry – The curvature of the eye A-constant – A constant that comes with the IOL Master Axial length – The distance between the anterior and posterior poles of the eye.

Slit-Lamp/Anterior Segment Photography The five types of slit-lamp illumination Illumination Meaning Direct Illumination is directly on area of interest Indirect Illumination is on another structure than the structure of interest Diffuse Illuminates entire area (nonspecific) Retroillumination Illuminates structure behind structure of interest Tangential Illuminates area across the surface of a structure Fundus Photography http://en.

Measure Measurements that help the optometrist properly fit contact lenses. Keratometry – This is a measure of the curvature of the eye using a keratometer. Iris Diameter – The diameter of the iris measured in millimeters. Refractive error – This is obtained by using the phoropter. Vertex Distance – This is the distance between the back surface of the glasses and the front of the cornea. Patient Instruction Instructions for patients using soft contact lenses include:

Amsler Grid Amsler Grids are just graph paper with a dot in the middle which the patient is supposed to focus on. Patients cover one eye while looking at the Amsler Grid. It is then the technicians job to ask questions about what they see. Amsler Grids are only used to test the central 20 degrees of a patients field of vision not the peripheral. If a patient is complaining of distortions it is important to use the Grid so that the patient can mark where distortions are seen.

Before reading this section I would recommend at least skimming Review of Ocular Diseases so that you are confident with common pathologies before you read about how those pathologies are treated surgically. General What is a minor procedure? A minor procedure is a simple procedure that can be perfumed with minimal risk. Many of these procedures are performed in the clinic. Examples of minor procedures are chalazion removal, punctal plug insertion, and foreign body removal.

Third-Party Coding Current procedural terminology (CPT) pronounced “captain” is how healthcare providers communicated their services to insurance companies. When collecting histories ask the seven questions required by CPT. The International Classification of Diseases (ICD) are diagnosis codes that allow all healthcare providers to communicate with each other. Government and Institutional Rules and Regulations The Health Insurance Portability and Accountability Act (HIPAA) – This act protects patients personal health information.

Visual Acuity Visual acuity is tested by asking the patient to read letters of different sizes. Visual acuity is broken into two pieces a numerator, the top number, and the denominator, the bottom number. The numerator represents the test distance. The denominator is the number that represents what the patient can see. For example: 20⁄20 Means that at 20 feet the patient can see what a normal eye can see at 20 feet.

First I highly recommend that you go through this tutorial. This is the best resource I have found on refraction. After you have gone through the plus and minus cylinder refraction tutorials read the rest of this post. Refractive Errors General Eye Shapes Emmetropia: This is a normal eye “well-proportioned” Myopia: This is nearsightedness. This is an eye that can see near objects well, but can’t see distant objects well.

Keratometry is the measure of the curvature of the cornea. Corneal Curvature The cornea has the most refractive power. Even for then the lens. The average thickness of the cornea is 0.5 mm(100 um). Corneal curvature is measured in millimeters/diopter. With the rule vs against the rule. With-the-rule astigmatism means that the strongest axis is the vertical axis (90 degrees) in plus cylinder which is the same as 180 degrees minus cylinder.

Before reading this section please brush up on spectacle skills to make sure that you know how to transpose. Automated Lensometry The automated lensometer is a lensometer that does all of the work for you. Just line of the lens then the machines beeps and spits out the reading. As long as you have selected the correct cylinder type you can’t really go wrong. Advantages to using the automated lensometer

Goldmann Applanation Tonometer The word applanate means to flatten. The purpose of applanation tonometry is to find ocular pressure. This follows the formaula Pressure = Force/Area. The applanation tonometer flattens a known area (3.06mm) with a given force to give pressure. Clean The Goldmann Applanation Tonometer may be cleaned by wiping with soap and water. While cleaning don’t bend the arm of the tonometer and make sure that the readings on the tonometer head are set to zero and level when finished.

Office Antisepsis Know the difference between these three words: Disinfection – inhibition of microorganisms Sterilization – destruction of microorganisms Sanitation – clean enough to be healthy Disinfection involves the destruction and inhibition of microorganisms on any surface. Germicides disinfect non-living surfaces, such as the counter tops in the clinic. Antiseptics disinfect living surfaces, such as you hands. I had a hard time trying to remember the difference between germicides and antiseptics.

Measure This section of the test is going to test your knowledge of pupil size. Two terms to know here are miotic and mydriatic. Miotic pupils are smaller than 2mm. Mydriatic is a pupil size larger than 6mm. Memorization Trick: Miotic is small like a tick. Mydriatic is big and dramatic. Compare Anisocoria is when the pupils are unequal sizes. This may happen after a traumatic incident. Know the difference between direct pupillary response and consensual pupillary response.

Introduction to muscles and muscle movements There are six muscles of the eye. Four of them are rectus muscles, meaning that they yank the eye straight back toward the origin of the muscle. These four muscles are either medial, near the nose, lateral, near the temple, superior, above the eye, inferior, below the eye. The other two muscles are oblique muscles which means that they pull the eye at an angle causing a slight toric motion.

This was a difficult section for me to study. I feel like the best way to get through this sections is to do some hard core memorization. I have included some tables. I know that a lot of times when I see a table in a book I just skip is, but treat this table like a check list of things to know. Make sure you can identified the instruments you are required to identify and know how to clean those instruments.

Pre Test Day When you pass your JCAT you will get an email which will lead you to a website to set up a time to take your test at a Person View Testing Center. Look up the directions to the testing center and get an estimate of how much time it will take you to get to the testing center. Also take into account traffic of you are traveling during rush hour.

What makes a prescription? If the eye were a perfect sphere then all we would need to correct vision would be a sphere lens. Though there are many people who can be corrected with a sphere lens many patients require a spherocylindrical lens because they have astigmatism. A spherocylindrical lens is made up of sphere power and cylinder power.   Optometrists and ophthalmologists think of spherocylindrical lenses differently. Ophthalmologists think of adding the sphere and the cylinder.

  Outline General History Presenting Complaint Sign vs Symptom Double Vision Injuries to the eye Past Ocular History Past Medical History Medications Social History Family History   General History A history is obtained by asking specific questions. Try to condense the patient’s story to only include pertinent facts. You need to be like a detective and search for pertinent facts.

1. You don’t repeat material Repeat, Repeat, Repeat The more times you repeat something the longer you remember it. When I went through the Exam Review packets I would go through about 20 questions at a time then grade myself. If my score was an 80% or higher I would move on if not then I would repeat that set of questions. Why? If I was missing more than 80% of a set of questions that means that I really did not understand that set.

The COA will give you basic knowledge to help you become a more competent tech. You will find that as you study you will learn things that you never heard of before. I learned why a rose bengal drop was used and the differences between soft and hard contact lenses. You will learn something new and you will become more competent because of it. The COA will give future employers more confidence in hiring you The general trend in jobs for ophthalmic assistants is going up.

I created this 10 week study schedule that requires a little less than 1 hour a day. I chose to use my lunch hour because I wanted to focus on family at home. You will need the Certified Ophthalmic Assistant Exam Review ManualThere are five columns the first column represents the chapter from the Certified Ophthalmic Assistant Exam Review Manual. The second column is that name of the chapter. There third column represents the percentage of questions on the actual COA exam.

I wanted to lay out a few ways that you can become a COA. 1. 1,000 hours of work Experience + JCAT + COA Exam This is the most common way to become a COA. You have to work for an ophthalmologist for 1,000 hours (6 months full time) and pass the exam. You will also have to be sponsored by a doctor before you can set a test date.