New93 role standards, now public
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Role standards

Dental and vision

Ophthalmic assistant

What an entry-level ophthalmic assistant must do reliably under an ophthalmologist's direction: take an accurate history, measure acuity, pupils and pressure correctly, give drops safely under standing orders, prepare the patient for the doctor, and get anything urgent to the doctor at once. Drawn from the IJCAHPO Certified Ophthalmic Assistant (COA) examination.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
4
Version
1

Built from International Joint Commission on Allied Health Personnel in Ophthalmology, Centers for Disease Control and Prevention. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent ophthalmic assistant does on day one, dimension by dimension.

Clinical skills

  • Measures acuity, pupils and pressure accurately and the same way every time, pinholes reduced vision, and does not measure pressure on an eye that may be ruptured.
  • Prepares the room, patient and instruments for an in-office procedure, keeps the field clean, and supports the doctor and patient through it.

Workflow and tools

  • Records each history item and measurement as it was obtained, with the eye and method, and never records what was not done.
  • Opens the right patient's chart, finds the flags and history that matter before starting, and enters data under their own login.

Patient communication

  • Takes a history in a consistent structure - the complaint in detail, eye and medical history, medicines, allergies and family history - and follows up an answer that could be urgent.
  • Explains tests and drops in plain words the patient can use, adjusting for vision, hearing and language.

Compliance and safety

  • Instils eye drops only under a doctor's order or standing order, after confirming patient, eye, drug, strength and allergies, and checks the chart for any reason not to dilate.
  • Disinfects every instrument that touches the eye between patients by the method the manufacturer and practice require, so infection cannot pass from one patient to the next.

Role knowledge

  • Does the tasks the ophthalmologist has delegated and they have been trained for, and leaves diagnosis, interpretation and treatment decisions to the doctor.
  • Recognizes symptoms and findings that cannot wait, starts any first aid their protocol requires, gets the doctor now, and confirms the doctor has taken it on.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Measures the pressure with any tonometer, including an air-puff or handheld device, or presses on the eye or lids, when the history or appearance suggests a penetrating injury or ruptured globe.

    Pressure on an open eye can push its contents out through the wound and turn a repairable injury into a lost eye.

  • Would instil a drop without confirming the patient, eye, drug and strength against an order or standing order, or would dilate a patient whose chart flags narrow angles, a do-not-dilate instruction or an allergy to the drop without asking the doctor first.

    The wrong drop can cause an allergic or systemic reaction, and dilating a narrow angle can trigger an attack of angle closure that damages the optic nerve within hours.

  • Would record a measurement or test that was not done, copy a value from a previous visit as today's, or change a reading to what was expected.

    The doctor makes treatment decisions from those numbers, and a false entry is fraudulent documentation in every jurisdiction.

  • Continues the routine work-up, or leaves the finding in the chart for the doctor to see in turn, when the patient has a sign that threatens sight today - sudden vision loss, a painful red eye with halos or vomiting, a new shadow or shower of floaters, a chemical in the eye, or a worse eye after surgery - instead of acting and getting the doctor now.

    These conditions cost sight by the hour, and the delay is the harm.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not diagnose, explain what results mean, or advise on treatment.Tells the patient the doctor will go through the results, and passes on their questions.
  • Does not give any drop or medicine without a doctor's order or standing order, and does not change one.Follows written orders and asks the doctor when the chart gives any reason to pause.
  • Does not perform a test or procedure they have not been trained and signed off for, or one their state reserves for licensed clinicians.Says so, asks for training and supervision, and leaves the task to someone qualified meanwhile. Delegation rules vary between states.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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