• 50 questions

JCAHPO COT Practice Test

Unofficial Certified Ophthalmic Technician practice test: questions spread over the content areas of the COT exam.

A deviation is absent with both eyes open and appears only when one eye is covered. What is it called?

Pick an answer, then press Check answer. Then you see Correct or Not quite, with the reason. Keys: A to D pick, Enter checks.

Print covers the next 40 questions. Share this set copies a link to the same questions in the same order.

Exam mode: 40 questions, 36 minutes.

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Unofficial practice questions, not affiliated with the International Joint Commission on Allied Health Personnel in Ophthalmology. Bank checked October 12, 2026.

The real exam, as IJCAHPO describes it

Length
200 multiple-choice questions in 180 minutes.
Second part
The COT Skill Evaluation, listed at 120 minutes for a first attempt. Certification needs both parts.
Deadline
Both parts must be finished within 24 months of the application's approval.
Where
A Pearson VUE test center, scheduled after the confirmation notice arrives.
Owner's practice exam
None for the multiple-choice examination. One is offered for the Skill Evaluation, for a fee.

Checked October 12, 2026 against Certified Ophthalmic Technician page and examination content areas, jcahpo.org. Rules change, so confirm with the agency itself before your test.

IJCAHPO's own COT page

Next step CMA practice examCCMA practice test

All 50 questions

History and visual acuity 4

  • A patient cannot make out any letter on the eye chart. How is acuity usually recorded next? MedlinePlus Medical Encyclopedia, Visual acuity test, How the Test is Performed. Outline: IJCAHPO COT content areas, Visual Assessment.
  • A patient standing 20 feet from the chart reads the 20/40 line. What does the 40 mean? MedlinePlus Medical Encyclopedia, Visual acuity test, Normal Results. Outline: IJCAHPO COT content areas, Visual Assessment.
  • A technician opens a new patient's history with the eye complaint and past glasses or contact lenses. What else does the history cover? MedlinePlus Medical Encyclopedia, Standard eye exam, How the Test is Performed. Outline: IJCAHPO COT content areas, History and Documentation.
  • Acuity of 20/80 improves to 20/25 when the patient looks through a pinhole occluder. What does the improvement suggest? Wikipedia, Pinhole occluder. Outline: IJCAHPO COT content areas, Visual Assessment.
Show all 50 questions (46 more)

Visual fields and pupils 4

  • A patient fixing on the center dot of an Amsler grid says some of the lines look wavy and broken. What does this point to? MedlinePlus Medical Encyclopedia, Home vision tests, What Abnormal Results Mean. Outline: IJCAHPO COT content areas, Visual Field Testing.
  • A patient has a drooping upper lid, a smaller pupil and less sweating, all on the same side of the face. Which condition fits? MedlinePlus Medical Encyclopedia, Horner syndrome, Symptoms. Outline: IJCAHPO COT content areas, Pupil Assessment.
  • In the swinging-flashlight test, both pupils dilate each time the light moves from the right eye to the left eye. What does this show? Wikipedia, Marcus Gunn pupil, Relative afferent pupillary defect. Outline: IJCAHPO COT content areas, Pupil Assessment.
  • Which visual field check needs no instrument: the examiner sits facing the patient, who covers one eye and says when the examiner's hand comes into view? MedlinePlus Medical Encyclopedia, Visual field, How the Test is Performed. Outline: IJCAHPO COT content areas, Visual Field Testing.

Tonometry, keratometry and biometry 7

  • A dense cataract hides the back of the eye. Which test lets the doctor look for a retinal detachment behind it? MedlinePlus Medical Encyclopedia, Eye and orbit ultrasound, Why the Test is Performed. Outline: IJCAHPO COT content areas, Biometry.
  • A patient's eye pressure reads high and the doctor wants to know how far the cornea is skewing the number. Which test is ordered? MedlinePlus Medical Encyclopedia, Tonometry, Normal Results. Outline: IJCAHPO COT content areas, Supplemental Testing.
  • During Goldmann applanation tonometry the examiner turns the dial while watching two green semicircles. When is the pressure read? Wikipedia, Ocular tonometry, Goldmann tonometry. Outline: IJCAHPO COT content areas, Tonometry.
  • What does a keratometer measure? Wikipedia, Keratometer. Outline: IJCAHPO COT content areas, Keratometry.
  • What does A-scan biometry measure before cataract surgery? Wikipedia, A-scan ultrasound biometry. Outline: IJCAHPO COT content areas, Biometry.
  • Which applanation reading falls inside the normal range of eye pressure? MedlinePlus Medical Encyclopedia, Tonometry, Normal Results. Outline: IJCAHPO COT content areas, Tonometry.
  • Which test records the electrical response of the rods and cones to flashes of light, as waves called A and B? MedlinePlus Medical Encyclopedia, Electroretinography. Outline: IJCAHPO COT content areas, Supplemental Testing.

Ocular motility 3

  • A deviation is absent with both eyes open and appears only when one eye is covered. What is it called? Wikipedia, Cover test. Outline: IJCAHPO COT content areas, Ocular Motility Testing.
  • Wearing red-green glasses for the Worth four dot test, a patient reports seeing five lights. What does this mean? Wikipedia, Worth 4 dot test. Outline: IJCAHPO COT content areas, Ocular Motility Testing.
  • Which test measures a tropia by adding prism until the corneal light reflex is centered? Wikipedia, Hirschberg test, Krimsky Test. Outline: IJCAHPO COT content areas, Ocular Motility Testing.

Lensometry, refraction, optics and contact lenses 9

  • A patient brings in a pair of glasses with no record of the prescription. Which instrument reads their sphere, cylinder, axis and add? Wikipedia, Lensmeter. Outline: IJCAHPO COT content areas, Lensometry.
  • A patient looks through a -4.00 D lens at a point 5 mm from its optical center. By Prentice's rule, how much prism is induced? Wikipedia, Prism correction, Prentice's rule. Outline: IJCAHPO COT content areas, Optics and Spectacles.
  • During retinoscopy the reflex moves in the same direction as the streak is swept. What is this movement called, and in whom is it seen? Wikipedia, Retinoscopy, Static Retinoscopy. Outline: IJCAHPO COT content areas, Refraction, Retinoscopy and Refinement.
  • Glasses no longer sharpen the vision of a patient with keratoconus. Which correction can most often bring vision to 20/20? MedlinePlus Medical Encyclopedia, Keratoconus, Symptoms. Outline: IJCAHPO COT content areas, Contact Lenses.
  • On the duochrome test a patient says the letters on the red side look clearer. What is the next step? Wikipedia, Duochrome test, Testing. Outline: IJCAHPO COT content areas, Refraction, Retinoscopy and Refinement.
  • Parallel light enters a +4.00 D lens. How far from the lens does it come to a focus? Wikipedia, Dioptre. Outline: IJCAHPO COT content areas, Optics and Spectacles.
  • Transpose +2.00 -1.50 x 180 into plus cylinder form. Wikipedia, Eyeglass prescription, Cylinder component. Outline: IJCAHPO COT content areas, Refraction, Retinoscopy and Refinement.
  • When a glasses prescription is converted for contact lenses, beyond about what power does vertex distance become significant? Wikipedia, Vertex distance. Outline: IJCAHPO COT content areas, Contact Lenses.
  • Which contact lens habit is singled out as a cause of corneal ulcers? MedlinePlus Medical Encyclopedia, Corneal ulcers and infections, Causes. Outline: IJCAHPO COT content areas, Contact Lenses.

Microbiology, pharmacology and surgical assisting 7

  • An assistant wearing sterile gloves touches a non-sterile surface while setting up. What should happen next? MedlinePlus Medical Encyclopedia, Sterile technique, Putting on Your Gloves. Outline: IJCAHPO COT content areas, Surgical Assisting.
  • Cyclopentolate is instilled before a child's refraction. What does a cycloplegic drug do? Wikipedia, Cycloplegia. Outline: IJCAHPO COT content areas, Pharmacology.
  • Dilating drops carry a particular risk in an eye whose drainage angle can close. What is that risk? MedlinePlus Medical Encyclopedia, Glaucoma, Causes. Outline: IJCAHPO COT content areas, Pharmacology.
  • How does an autoclave sterilize surgical instruments? Wikipedia, Autoclave. Outline: IJCAHPO COT content areas, Surgical Assisting.
  • In LASIK, which laser removes a thin layer of corneal tissue to reshape the cornea? MedlinePlus Medical Encyclopedia, LASIK eye surgery, Description. Outline: IJCAHPO COT content areas, Surgical Assisting.
  • Soap and water are not at hand between patients. How strong should the hand sanitizer be? MedlinePlus Medical Encyclopedia, Handwashing, Information. Outline: IJCAHPO COT content areas, Microbiology.
  • With which patients are standard precautions followed? MedlinePlus Medical Encyclopedia, Isolation precautions, Standard Precautions. Outline: IJCAHPO COT content areas, Microbiology.

Patient services and ethics 7

  • A caller says drain cleaner has splashed into one eye. What is the first instruction? MedlinePlus Medical Encyclopedia, Eye emergencies, Causes. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.
  • A parent asks which eye gets the patch in amblyopia treatment. What is the answer? MedlinePlus Medical Encyclopedia, Amblyopia, Treatment. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.
  • A patient collapses in the waiting room and is not breathing. In adult CPR, how many chest compressions are given before 2 breaths? MedlinePlus Medical Encyclopedia, CPR - adult and child after onset of puberty, First Aid. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.
  • A patient phones about sudden new floaters, flashes of light and a curtain across part of the vision in one eye. How is the visit scheduled? MedlinePlus Medical Encyclopedia, Retinal detachment, When to Contact a Medical Professional. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.
  • A technician counts a resting adult's pulse. Which rate is within the normal range? MedlinePlus Medical Encyclopedia, Vital signs. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.
  • Before a patient signs a consent form for a laser procedure, what must be true for the consent to be informed? MedlinePlus Medical Encyclopedia, Informed consent - adults, What is Informed Consent?. Outline: IJCAHPO COT content areas, Medical Ethics, Legal and Regulatory Issues.
  • What should a patient be told before dilating drops are put in? MedlinePlus Medical Encyclopedia, Standard eye exam, Risks. Outline: IJCAHPO COT content areas, Ophthalmic Patient Services and Education.

General medical knowledge 3

  • What does the eye doctor see in the proliferative stage of diabetic retinopathy that is absent in the early stage? MedlinePlus Medical Encyclopedia, Diabetes and eye disease, Exams and Tests. Outline: IJCAHPO COT content areas, General Medical Knowledge.
  • Where does aqueous humor leave the eye? MedlinePlus Medical Encyclopedia, Glaucoma, Causes. Outline: IJCAHPO COT content areas, General Medical Knowledge.
  • Which part of the retina gives sharp, detailed central vision? MedlinePlus Medical Encyclopedia, Macula lutea. Outline: IJCAHPO COT content areas, General Medical Knowledge.

Imaging and photography 6

  • How is the dye given for fluorescein angiography? MedlinePlus Medical Encyclopedia, Fluorescein angiography, How the Test is Performed. Outline: IJCAHPO COT content areas, Ophthalmic Imaging.
  • What does the green filter do in red-free fundus photography? Wikipedia, Fundus photography, Modes. Outline: IJCAHPO COT content areas, Photography and Videography.
  • Which dye test is used to examine choroidal blood flow, using a dye that fluoresces in near-infrared light? Wikipedia, Indocyanine green angiography. Outline: IJCAHPO COT content areas, Ophthalmic Imaging.
  • Which slit-lamp illumination technique is used to see the outline of the corneal endothelium? Wikipedia, Slit lamp, Specular reflection. Outline: IJCAHPO COT content areas, Photography and Videography.
  • Which structures does a fundus photograph mainly show? Wikipedia, Fundus photography. Outline: IJCAHPO COT content areas, Photography and Videography.
  • Which test uses near-infrared light and interferometry to produce micrometer-level, depth-resolved images of the retina? Wikipedia, Optical coherence tomography. Outline: IJCAHPO COT content areas, Ophthalmic Imaging.

How this list was compiled: Our own questions, written to the Certified Ophthalmic Technician (COT) examination content areas that the International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO) publishes (https://documents.jcahpo.org/documents/Certification/IJCAHPO_Core_Criteria_Exam_Content_COTandCOMT.pdf and https://documents.jcahpo.org/documents/Certification/IJCAHPO_Core_Examination_Content_Areas.pdf, read 2026-10-12). The COT column gives: History and Documentation 3%, Visual Assessment 7%, Visual Field Testing 3%, Pupil Assessment 4%, Tonometry 4%, Keratometry 3%, Ocular Motility Testing 6%, Lensometry 3%, Refraction, Retinoscopy and Refinement 5%, Biometry 5%, Supplemental Testing 2%, Microbiology 3%, Pharmacology 3%, Surgical Assisting 6%, Ophthalmic Patient Services and Education 12%, General Medical Knowledge 5%, Optics and Spectacles 5%, Contact Lenses 5%, Ophthalmic Imaging 7%, Photography and Videography 6%, Equipment Maintenance and Repair 1%, Medical Ethics, Legal and Regulatory Issues 2%. The bank holds 50 questions, about one for each two percent; Equipment Maintenance and Repair has none. Every fact was read on 2026-10-12 in the public source the question names: the MedlinePlus Medical Encyclopedia (National Library of Medicine) for 28 questions and Wikipedia articles on ophthalmic instruments and tests for 22. Three answers are arithmetic worked from the rule the source gives. Licence: Questions, choices and explanations are original work of this site.

How it works

This free, unofficial JCAHPO COT practice test has 50 questions of our own for the Certified Ophthalmic Technician multiple-choice exam. It is not affiliated with or endorsed by the International Joint Commission on Allied Health Personnel in Ophthalmology (IJCAHPO).

Read the full guide

What the COT exam covers

IJCAHPO's content areas, read at jcahpo.org on October 12, 2026, give each area a share of the exam: ophthalmic patient services and education 12%, visual assessment and ophthalmic imaging 7% each, ocular motility, surgical assisting and photography 6% each, down to equipment maintenance at 1%. This certified ophthalmic technician practice test follows those shares.

A study guide by content area

Read as a JCAHPO COT study guide, the questions sort into nine topics, from history and acuity to imaging, and every explanation names the article and section behind the answer.

Timing

The timed test here asks 40 questions in 36 minutes, the pace of the real exam's 200 in 180.

  • Wikipedia is the named source for 22 instrument questions. Open the link and its references if your textbook words a rule differently.

Questions and answers

Is there an official JCAHPO COT practice test?

IJCAHPO's COT page says the COT multiple-choice examination has no practice examination; it offers one for the Skill Evaluation. This page is a separate bank, and none of its questions comes from the real exam.

How many questions are on the COT exam?

200 multiple-choice questions in 180 minutes, by IJCAHPO's COT page and content areas, read October 12, 2026. Certification also requires the COT Skill Evaluation, which IJCAHPO lists at 120 minutes for a first attempt.

What is a good certified ophthalmic technician study guide?

Start from IJCAHPO's content areas, the list the exam is built on, and study the heaviest first: patient services, visual assessment, imaging. IJCAHPO offers its own study cards and guides; this page is free practice on the same areas.

Who can take the COT exam?

IJCAHPO lists four pathways: graduates of an accredited technician program, current Certified Ophthalmic Assistants with 2,000 hours of work, current certified orthoptists, and assistants on a fast track with 6,000 hours. Check jcahpo.org before you apply.

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