Ophthalmic Technician Duties
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 a an ophthalmic technician for the past 21 years, and I enjoy my career. What I enjoy the most was 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 patients complaint or history of injury/illness
- Visual acuity testing – checking the patient’s vision
- Lensometry – reading a patients 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
- Instillation of 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.
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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 COT’s 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 advance 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.
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.
A Slit Lamp
Certified Ophthalmic Medical Technologist
COMTs are the top level technicians and are typically found in a management role such as a clinic supervisor or director. 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
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 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.
You may also enjoy reading my related article: How to Become an Ophthalmic Technician.
Questions & Answers
© 2012 Melissa Flagg COA OSC