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Certified Refractionist Certificate of Completion

Uncorrected refractive error is the single most critical eye care issue around the world and the most easily addressed cause of vision loss. Refraction is a testing procedure that uses optical principles and specialized equipment to measure the focusing characteristics of an eye, or the refractive error. This course will cover the basics of refraction including physiological optics which describes how the eye works as an optical system, the anatomy of the relevant parts of the eye, refractive states of the eye, autorefraction techniques, retinoscopy, and refinement. The course rounds out with special techniques used to further refine the binocular glasses prescription.

Course Requirements

This is a self-paced and self-directed course composed of on-line courses, readings, and simulations designed to prepare the student for clinical time where practice and competency of refraction skills will be practiced.




  • Ocular Anatomy and Physiology (IUSM 1000)
  • Visual Acuity (JCAP 6110)

Learning Outcomes

After successful completion of this course, you will be able to:

  1. Describe physiologic optics and refractive states of the eye
  2. Perform automated refraction
  3. Perform retinoscopy
  4. Perform refinement

Learning Objectives

After successful completion of this course, you will be able to:

Physiologic OpticsThe Eye as an Optical System
Refractive States of the EyeGeneral Principles
InstrumentationPhoropter (Plus and Minus Cylinder)
Retinoscope (Plus and Minus Cylinder)
Cylinder (Power and Axis)
RefinementGeneral Principles
Cylinder (Power and Axis)
Reading Add
Cycloplegic Refraction
Special TechniquesFogging
Duochrome Test
Vertex Distance

Course Materials

IJCAHPO and its test vendors do not discriminate against individuals with disabilities and make every effort to reasonably accommodate candidates with documented disabilities as defined by the Americans with Disabilities Act (ADA). If you have a disability as defined under the ADA, you must notify IJCAHPO by submitting a form regarding your request from your physician or a qualified healthcare professional.

Required Courses

  • IJCAHPO University
    • Optics and Instrumentation for Refraction
    • Plus Cylinder Retinoscopy and Refinement
    • Minus Cylinder Retinoscopy and Refinement

Required Reading

  • The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel, 11th Edition, Harold A. Stein, Raymond M. Stein, Melvin I. Freeman, and Rebecca L. Stein
    • Chapter 1: pp 1-10
    • Chapter 3: pp 27-42
    • Chapter 10: pp 152-159
    • Chapter 11: pp 183-184
    • Chapter 12: pp185-207

Supplemental Courses

  • IJCAHPO University
    • JCAV 4082 “Refractometry: It’s More Interesting and Enjoyable than I Thought”JCAV 4750 Practical Refractometry Plus Cylinder
    • JCAV 4064 Refractions: What Do Those Numbers Really Mean?

Supplemental Reading Refinement 7: Challenges in Refraction: Troubleshooting Refraction Problems



  • Checklists are step-by-step directions on how to perform each of the skills listed below. The checklists provide steps for the procedures providing the student with the correct and vetted steps for the procedures. This tool can be used for learning and for assessment.
    • Automated refraction
    • Retinoscopy plus and minus
    • Refinement plus and minus


  • A rubric is an assessment tool that breaks a task down into individual steps and the student can be assessed on the individual steps. This method creates an in-depth assessment of the entire task by evaluating each step in the task. This tool can be used for learning and for assessment.


  • A computer simulation of the skill is used for learning the steps of the task with or without supervision. This allows the student to be prepared to perform the task once they are in the clinical setting.


  • Multiple choice examination