COT® Skill Evaluation: What’s Tested and How It’s Scored

The COT® Skill Evaluation is the hands-on half of the COT exam. You perform seven skills in 120 minutes: lensometry, keratometry, visual fields, ocular motility, retinoscopy, refinement and tonometry. You’re graded on how you perform each skill and whether your result is right, and you must pass all seven. Missed skills can be retaken within 24 months of approval.

Last checked Nov 2, 2026. Confirm fees and dates with the certifying body. optical.education is independent and is not affiliated with or endorsed by IJCAHPO. Disclaimer.

The seven skills

The whole first attempt has a 120-minute limit (IJCAHPO COT page). When you retest a single skill, each one has its own time limit:

Lensometry, retinoscopy and refinement can be done in either plus or minus cylinder, so use the one you work in. Source: IJCAHPO COT requirements (PDF). This PDF is older and still uses the JCAHPO name, so check the current details in your confirmation letter.

Scoring and results

Two things are graded for each skill: your technique (how you do it) and your accuracy (whether your result is right). Visual fields is scored on technique only. You must pass all seven skills.

• Pass: you passed all seven skills.
• Condition: you passed some skills but not all. Retest only the ones you missed.
• Fail: you passed none of the skills.

Source: IJCAHPO COT requirements (PDF).

Retesting

You can retest up to five times, which is six attempts in total, within 24 months of your application approval (COT requirements; the Core Criteria Handbook also says up to six times). The current fee for each Skill Evaluation retest is $85 (Fee Schedule and Timeline).

How to practice

• Take the official practice test. IJCAHPO’s practice Skill Evaluation costs $85. It doesn’t count as a formal attempt, but if you pass every skill, it counts as passed. No refund.
• Use the checklist. Your confirmation letter includes links to a tutorial and a step-by-step checklist. Practice each step in order.
• Time yourself. Work against the per-skill limits above.
• Get your technique checked. Technique is scored, not just the answer. Ask an experienced technician or your doctor to watch you.
• Warm up online. Our free lensometer, keratometer and applanation tonometer simulators help you practice reading the instruments. They don’t replace hands-on practice.

For eligibility and fees, see COT certification. COMT candidates who aren’t current COTs also take this test: see COMT certification.

COA®, COT® and COMT® are registered marks of IJCAHPO.