The COA® exam is 200 questions in 180 minutes. IJCAHPO’s content areas effective 8/1/2025 put History and Documentation at 9%, General Medical Knowledge and Patient Services at 8%, and Visual Assessment, Pupils and Tonometry at 7% each. Spend the week on those first, sit one full timed practice exam, then rest.
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COA® is a registered mark of IJCAHPO. This plan covers the last seven days; the longer plan and pacing advice are on how to study for the COA.
What the week must cover
The larger areas in IJCAHPO’s COA content areas, effective 8/1/2025 (checked Nov 2, 2026). The exam is 200 questions in 180 minutes per the COA page.
| Content area | Weight |
|---|---|
| History and Documentation | 9% |
| Ophthalmic Patient Services and Education | 8% |
| General Medical Knowledge | 8% |
| Visual Assessment | 7% |
| Pupil Assessment | 7% |
| Tonometry | 7% |
| Visual Field Testing | 6% |
| Pharmacology | 6% |
The 7-day plan
| Day | Focus | Task | Time |
|---|---|---|---|
| 1 | Diagnose | A timed COA practice set; tag misses by content area | 1.5–2 h |
| 2 | History and Documentation (9%) | Chief complaint, HPI, abbreviations; redo misses | 1.5 h |
| 3 | General Medical (8%) + Patient Services (8%) | Systemic disease links, emergencies, patient instructions | 2 h |
| 4 | Visual Assessment, Pupils, Tonometry (7% each) | Acuity notation, swinging flashlight, applanation simulator | 2 h |
| 5 | Pharmacology (6%) + Visual Fields (6%) | Drop classes and dilation steps, field basics; then a mixed set | 1.5 h |
| 6 | Full timed practice | 200 questions at exam pace, then review every miss | 3.5–4 h |
| 7 | Light review and rest | Missed questions, your quick-facts list, ID and route | 45 min |
Lensometry and tonometry drills
Ten minutes on the lensometer simulator (Lensometry is 3%) and longer on the applanation tonometer simulator (Tonometry is 7%). For drugs, use COA pharmacology.
Full timed practice
Use our COA practice tests. At 200 questions in 180 minutes you have about 54 seconds per question.
Readiness check
A self-check, not a prediction. IJCAHPO does not publish a passing percentage (see COA cost and passing score).
- I finished the timed set inside 180 minutes.
- No high-weight area is far behind the rest.
- I can explain each miss from day 6.
Test day at Pearson VUE
From IJCAHPO’s Core Criteria Handbook (checked Nov 2, 2026): bring two original, unexpired IDs with names that match your registration; personal items stay out of the room; you can’t eat or drink in the testing room; arriving over 15 minutes after your appointment time counts as a no-show. Scheduling is through Pearson VUE.
Frequently asked questions
Can I study for the COA exam in one week?
A week works for a final review if you already work in eye care and have studied before. It is not enough to learn all 22 content areas from scratch. IJCAHPO does not publish a recommended study length.
Source: IJCAHPO — COA Examination Content Areas, effective 8/1/2025 (PDF) (opens in a new tab)
What COA topics should I review last?
The highest-weight areas where you still miss questions, and quick facts that are easy to mix up, such as drop classes and normal pressure ranges. Leave low-weight areas you already know alone.
Source: IJCAHPO — COA Examination Content Areas, effective 8/1/2025 (PDF) (opens in a new tab)
How should I practice lensometry before the COA?
Lensometry is 3% of the 2025 COA outline, so keep it short. Run the lensometer simulator until you can read sphere, cylinder, axis and prism in under a minute, then move on.
Source: IJCAHPO — COA Examination Content Areas, effective 8/1/2025 (PDF) (opens in a new tab)
See also: Lensometer simulator
What should I bring to my COA exam at Pearson VUE?
Two original, unexpired IDs. The primary must be government-issued with your name, a recent photo and your signature; the second needs your name with a signature or a photo. Names must match your registration exactly. Personal items stay out of the testing room; a whiteboard is provided.
Source: IJCAHPO — Core Certification Criteria Handbook (PDF) (opens in a new tab)
Should I reschedule my COA exam if I’m not ready?
Weigh it against the rules in IJCAHPO’s handbook: you must test within the 90 days IJCAHPO gives you, changes made 30 or more days out are free, later changes can cost a Pearson VUE fee, and arriving over 15 minutes after your appointment time counts as a no-show. Confirm the current rules before deciding.
Source: IJCAHPO — Core Certification Criteria Handbook (PDF) (opens in a new tab)
Official sources
- IJCAHPO — Certified Ophthalmic Assistant (COA®) (opens in a new tab)
- IJCAHPO — COA Examination Content Areas, effective 8/1/2025 (PDF) (opens in a new tab)
- IJCAHPO — Core Certification Criteria Handbook (PDF) (opens in a new tab)
- Pearson VUE — IJCAHPO (opens in a new tab)
Last reviewed . Requirements, fees, and dates change — always confirm with the official source before you register or apply. ABO-NCLE and IJCAHPO are the only authorities for their own exam facts, so those facts rest on a single source.