COA Cheat Sheet 2026

The 30 highest-yield COA facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What is the primary purpose of performing retinoscopy? → Determine refractive error objectively
2. What is the recommended patient education regarding hydrogen peroxide contact lens care systems? → Lenses must complete a full neutralization cycle (minimum 6 hours) before insertion
3. In the SOAP note format, where would the ophthalmic assistant's measurement of the patient's visual acuity and intraocular pressure be documented? → Objective
4. When obtaining a patient history, which question is MOST important to ask when a patient reports sudden painless vision loss in one eye? → Have you had any recent head trauma or vascular events?
5. A patient with a right CN VI (abducens) palsy will show which characteristic finding on ocular motility testing? → Right eye cannot abduct in right gaze
6. Which of the following conditions is NOT hereditary? → Conjunctivitis
7. Which of the following BEST describes the proper test distance for standard Snellen distance visual acuity testing? → 20 feet (6 meters)
8. OCT (Optical Coherence Tomography) in glaucoma management primarily measures: → Retinal nerve fiber layer thickness
9. When documenting the Chief Complaint (CC), the ophthalmic assistant should: → Record the primary reason for the visit in the patient's own words.
10. Which of the following MOST qualifies as a chief complaint? → Eye fatigue
11. The trabecular meshwork is clinically significant because it: → Is the primary drainage site for aqueous humor
12. Which condition is most directly associated with chronic corneal hypoxia from extended contact lens wear? → Corneal neovascularization (pannus)
13. Which type of glaucoma is characterized by a narrow or closed iridocorneal angle that obstructs aqueous outflow? → Angle-closure glaucoma (ACG)
14. A patient switches from glasses (spectacle Rx: -5.00 D) to contact lenses. Due to vertex distance, the expected contact lens power will be approximately: → Less minus than the spectacle prescription
15. Which of the following is considered the 'gold standard' for measuring intraocular pressure? → Goldmann applanation tonometry
16. Which of the following is the CORRECT procedure for occluding the eye NOT being tested during monocular visual acuity testing? → Place an opaque occluder firmly over the non-tested eye
17. What is the primary clinical reason for performing a stereoacuity test such as the Randot or Titmus Fly test? → To assess binocular fusion and depth perception
18. A patient denies taking any medications but mentions using 'natural eye drops for dryness' purchased at a health food store. How should the COA document this? → Document it under 'Current Medications' as an OTC/supplement product
19. A 5-year-old child is being tested for stereopsis. Which of the following tests would be most appropriate for this age group? → Titmus Fly Test
20. The term used to refer to symptoms due to uncorrected refractive error is ______ : → Asthenopia
21. Which of the following is the primary purpose of using Ishihara plates during a visual assessment? → To screen for red-green color vision deficiencies
22. Which history-taking category would not typically be pertinent when interviewing a patient with a chief complaint of headaches? → Ethnicity
23. When recording the history of present illness (HPI) for a patient reporting blurred vision, which element describes the QUALITY of the symptom? → 'Described as foggy, like looking through frosted glass'
24. Which instrument is used to measure corneal thickness (pachymetry)? → Pachymeter
25. The use of topical steroids may induce which of the following? → Cataracts
26. Pupil constriction (miosis) and dilation (mydriasis) are controlled by which iris muscles? → Sphincter muscle for miosis and dilator muscle for mydriasis
27. Which device is used to calculate intraocular lens power before cataract surgery? → Optical biometry device (e.g., IOL Master)
28. The Amsler grid is specifically used to detect abnormalities in: → Central macular function
29. A-scan ultrasound biometry is primarily performed to measure: → Axial length of the eye
30. Which layer of the cornea has the greatest capacity for regeneration after injury? → Epithelium