New93 role standards, now public
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Role standards

Dental and vision

Ophthalmic technician

What an ophthalmic technician must do without close supervision: a complete, accurate work-up including refraction, applanation tonometry, fields and imaging, eye drops given safely under the ophthalmologist's orders, and urgent findings put in front of the doctor at once. Drawn from the IJCAHPO Certified Ophthalmic Technician (COT) examination.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
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 technician does on day one, dimension by dimension.

Clinical skills

  • Measures acuity, refraction, pupils, pressure and fields accurately and reproducibly, knows what makes each result unreliable, and does not perform a test that could harm the eye in front of them.
  • Acquires OCT, photographs and biometry of diagnostic quality, checks each against quality criteria before the patient leaves, and flags results that do not add up.

Workflow and tools

  • Records every measurement as it was obtained, with the method and conditions, so the doctor can trust and compare it.
  • Uses the record to find what matters before the work-up, enters data in the right patient's chart, and uses its correction path.

Patient communication

  • Takes a focused history that finds the symptoms, medicines and history that change what the doctor does today, in the patient's own words.
  • Explains tests, drops and what happens next in plain words the patient can use, adjusting for vision, hearing and language.

Compliance and safety

  • Instils eye drops only under an order or standing order, after confirming patient, eye, drug, strength, allergies and any reason not to dilate, and watches for a reaction.
  • Disinfects tonometer tips, gonioscopy lenses and contact probes to a validated method between every patient, so no infection passes from one eye to the next.

Role knowledge

  • Performs what the ophthalmologist has delegated and the state allows, and leaves diagnosis, prescribing and interpretation to the doctor.
  • Recognizes findings that cannot wait, starts the immediate action 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.

  • Performs applanation or any contact tonometry, 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.

  • Instils a drop without confirming the patient, eye, drug and strength against an order or standing order, or dilates a patient whose record flags narrow angles, a do-not-dilate instruction or an allergy to the drop, without checking with the doctor first.

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

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

    The doctor decides treatment on 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 sight-threatening finding - sudden vision loss, a very high pressure with pain or corneal clouding, a new curtain or shower of floaters, a chemical injury, or a worse eye after surgery - instead of acting and getting the doctor now.

    Angle closure, retinal artery occlusion, detachment, chemical burns and post-operative infection all 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, tell a patient what their results mean, or advise on treatment.Explains what the test measures, says the doctor will go through the results, and passes on the patient's questions.
  • Does not issue a spectacle prescription from their refraction, or start, stop or change a medicine, without the ophthalmologist's approval or order.Records the refraction for the doctor to review, and follows written orders and standing orders only.
  • Does not perform tasks the ophthalmologist has not delegated or that their state reserves for licensed clinicians.Works within the practice's written delegation and state rules, which vary, and asks when a task falls outside them.

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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