GENERAL SUMMARY:
Under direct supervision of the manager, the Leader-Ophthalmic Technician-Certified provides leadership to a staff of at least four employees. Performs leadership functions about 30% of the time and Ophthalmic Technician - Certified duties the remaining 70% of the time. Assists the ophthalmologist in the clinic setting. In addition to the assistant level skills, a certified ophthalmic technician must also demonstrate accuracy in measuring a refractive error, performing tests of ocular motility and other specialized diagnostic tests.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
Leadership Duties:
· Leads a group of four or more staff.
· Performs leadership function approximately 30% of the time.
· Assists in the selection, orientation, and training of new staff; and may provide input into performance appraisals.
· Schedules staff and distributes work assignments.
· Monitors workflow and makes appropriate work assignment adjustments.
· Provides professional expertise as needed.
· Develops an educational plan to address staff development.
· Assists in validating competencies of staff.
· Leads the daily Team Huddles before the start of clinic.
COT, COMT, CO Duties:
· Medical History Taking: Obtain and accurately record patient's medical and ocular history including chief complaint, medications, allergies, and review of systems in accordance with compliance guidelines. Select and complete appropriate forms and protocol as required by the supervising ophthalmologist and/or sub-specialist. Use approved medical abbreviations. May document for the physician in the clinical setting, not the surgical setting.
· Visual acuity testing: Perform visual acuity testing to determine the basic ability of a person to see both near and far, with and without correction. Conduct pinhole acuity test, glare test, and potential acuity test (e.g., BAT, PAM) Measure vision without charts (CF, HM, LP, etc.).
· Lensometry: Apply basic optics necessary to measure the power of corrective lenses using automated or manual lensometers. Verify spectacle lens power, bifocal addition power, mark optical centers, and detect prism, if present. Measure base curves. Verify prescribed and unwanted prism as ground-in or induced.
· Visual Fields: Perform confrontation visual field and screening tests using automated and/or Frequency Doubling perimetry. Detect central field abnormalities with an Amsler grid. Diagram confrontation field defects. Plot peripheral isopters using Goldmann-type perimeter. Identify visual field defects typical of various ophthalmic and neurologic conditions.
· Tonometry: Demonstrate proper aseptic technique and measure intraocular pressure with non-contact, digital and/or Goldmann applanation tonometers. Calibrate TonoPen and Goldmann applanation tonometers.
· Instrument maintenance: Care for, maintain, and perform minor servicing of exam room equipment. Maintain records, equipment manuals, and repair logs. Restock supplies as rooms are opened; protect and properly store instruments as rooms are closed. Replace light bulbs and fuses as needed. Troubleshoot electrical instrument failure. Calibrate special equipment (Goldmann perimeter, projectors, keratometers, applanation tonometers, etc.). Calibrate A-scan ultrasound equipment.
· Other specialized tests: Perform color vision testing with color plates. Measure pupil size and detect abnormalities in pupil reaction. Estimate anterior chamber depth by slit lamp evaluation. Obtain measurements using automated refractors and/or keratometers. Measure stereopsis with Titmus test. Evaluate reflex tear production with Schirmer's test strips. Measure corneal thickness with digital (ultrasonic) pachymeter. Measure axial length by contact and immersion A-scan ultrasound. Identify proper spike pattern required for visual axis alignment. Demonstrate methods for targeting and achieving appropriate post-operative refractive errors.
· Other patient services: Coordinate patient flow and appointments. Apply and remove eye dressings and shields. Instill drops and ointment into patient's eye as directed for completion of diagnostic evaluation of patient by ophthalmologist. Recognize the symptoms of allergic reactions to medications. Follow department protocol on prescription refill processing. Measure and record vital signs (blood pressure, pulse, and respirations). Provide patient education on tests - why done, when results are expected. Participate in telephone triage and assist trauma patients. May perform minor repairs of spectacles.
· Contact lens assisting: Take history from the patient on contact lens wear and identify problems. Perform visual acuity with contacts. Instruct patients on insertion, removal, care, and solutions for all types of lenses. Insert trial contact lenses. Order contact lenses for patients per doctor specifications and initiate purchase orders. Maintain contact lens stock and patient files. Care for contact lenses and ocular prosthetics and instruct patients in contact lens insertion and removal. May measure lens specification such as power, curves, diameter, edge and center thickness of all types of contacts. May clean and polish hard and gas permeable contacts. May check new contacts from lab and verify specifications. Measure corneal curvature with manual keratometers. Perform corneal topography and distinguish between normal and abnormal readings. Troubleshoot fitting problems.
· Refractometry: Enter spectacle data into Phoropter. Refine spectacle correction or automated findings using a Phoropter. Measure a refractive error by retinoscopy. Refine objective refraction using a Phoropter and/or trial lenses and trial frame.
· Calculate reading add at 40 centimeters (16 inches). Measure vertex distance.
· Ocular motility assessment: Measure near point of convergence. Use cover tests to identify deviations of alignment by type and amount. Distinguish between normal and abnormal binocular movements (versions and vergences).
· Photography: Identify instruments used for imaging in the eye. Set up for, explain, and prepare patient for IV fluorescein angiography (IVFA). Recognize and respond to possible complications of intravenous fluorescein angiography (IVFA) Obtaincolor fundus photos of the optic disc. Perform imaging of the optic nerve and retina (OCT) as required.
· Surgical Assisting: Set up and assist in non-refractive laser surgery (argon, YAG, etc.) and minor surgery. Prepare instrument tray for minor surgical procedures. Disinfect lenses and instruments that make contact with the eye. Maintain surgical instruments in accordance with OSHA standards. Properly gown and glove self and assist others in gowning and gloving. Select proper instruments using physician's preference for common ocular surgical procedures. Drape an ophthalmic surgical patient. Identify the sterile field and instruments and maintains aseptic technique. Clean, prepare, package, and sterilize microsurgical instruments. Identify instrumentation for refractive surgery and assist in refractive procedures. Set up ophthalmic surgical machines and instruments. Identify appropriate wound closure materials. Identify surgical medications, including anesthetics, miotics, mydriatics, viscoelastics, osmotic diuretics, enzymes, narcotics, and other medications as required.
EDUCATION/EXPERIENCE REQUIRED:
· High school diploma and a minimum of four (4) years of experience as a COT, COMT or CO required.
· Visual/hearing/verbal requirements: The ability to see details of objects at a close range (within a few feet of the observer). The ability to listen to and understand information and ideas presented through spoken words and sentences. Ability to communic
