100+ Free OSA Practice Questions

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Question 1

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When passing instruments to the surgeon during ophthalmic surgery, the scrub assistant should:

Pass tip-first into the surgeon's open palm so the surgeon must reorient

Pass with the working tip oriented away from the surgeon's hand and aligned with the intended use, in a smooth firm placement

Throw instruments to save time

Pass only when prompted by the circulator

to track

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Key Facts: OSA Exam

MCQ Items

IJCAHPO OSA

5% PVP-I

Endophthalmitis Prep

3 min before incision

NO N2O

After Gas Tamponade

IOP rise risk

Pearson VUE

Delivery

IJCAHPO

IJCAHPO OSA is the ophthalmic surgical assisting credential. 80 MCQ via Pearson VUE. Master phacoemulsification + IOL types (foldable acrylic, toric, multifocal/EDOF), 5% povidone-iodine endophthalmitis prophylaxis, intracameral cefuroxime (ESCRS), trypan blue for white cataracts/IFIS, vitrectomy gauges (20G-27G), gas tamponade NO-N2O/no-air-travel rules, and Joint Commission Universal Protocol time-out.

Sample OSA Practice Questions

Try these sample questions to test your OSA exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1What is the most common type of cataract surgery performed today?

A.Intracapsular cataract extraction

B.Extracapsular cataract extraction

C.Phacoemulsification

D.Couching

Explanation: Phacoemulsification is the most common cataract surgery worldwide. It uses ultrasound energy to emulsify the lens nucleus, which is then aspirated through a small clear corneal incision (typically 2.2 to 3.0 mm).

2What is the typical incision size for modern phacoemulsification cataract surgery?

A.0.5-1.0 mm

B.2.2-3.0 mm

C.6.0-8.0 mm

D.10.0-12.0 mm

Explanation: Modern phacoemulsification uses a clear corneal incision of approximately 2.2 to 3.0 mm, which is small enough to be self-sealing and accommodates foldable IOLs through an injector.

3What does the acronym BSS stand for in cataract surgery?

A.Bilateral Surgical Solution

B.Balanced Salt Solution

C.Buffered Sterile Saline

D.Basic Surgical Set

Explanation: BSS stands for Balanced Salt Solution, the irrigation fluid used during phacoemulsification. Its electrolyte composition is similar to aqueous humor, protecting corneal endothelial cells.

4Which three primary functions does a phacoemulsification machine provide simultaneously?

A.Cutting, suction, and electrocautery

B.Irrigation, aspiration, and ultrasound

C.Laser, vacuum, and infusion

D.Cryotherapy, irrigation, and aspiration

Explanation: The phaco machine simultaneously provides irrigation (BSS infusion to maintain anterior chamber depth), aspiration (vacuum to remove emulsified lens material), and ultrasound power (to fragment the lens nucleus).

5Which IOL material is most commonly implanted today through a small-incision injector?

A.PMMA (polymethylmethacrylate)

B.Foldable acrylic

C.Glass

D.Stainless steel

Explanation: Foldable acrylic (hydrophobic or hydrophilic) IOLs are the most common modern intraocular lenses. They fold inside an injector cartridge and unfold inside the capsular bag through a 2.2-3.0 mm incision.

6Which premium IOL is specifically designed to correct corneal astigmatism?

A.Toric IOL

B.Multifocal IOL

C.Monofocal IOL

D.Phakic IOL

Explanation: A toric IOL contains cylindrical power and must be aligned at a specific axis inside the capsular bag to neutralize the patient's corneal astigmatism.

7What is the purpose of capsulorhexis (continuous curvilinear capsulotomy or CCC)?

A.To create an opening in the posterior capsule

B.To make a continuous round opening in the anterior capsule for nucleus access

C.To stain the cornea

D.To remove the iris

Explanation: Capsulorhexis (CCC) creates a continuous, smooth-edged round opening (typically 5-5.5 mm) in the anterior capsule, allowing access to the nucleus and providing a strong rim for IOL placement in the bag.

8What is the typical diameter of a properly sized capsulorhexis?

A.1-2 mm

B.5-5.5 mm

C.8-9 mm

D.10-12 mm

Explanation: A capsulorhexis of 5-5.5 mm is ideal: large enough to allow nucleus removal and IOL implantation but small enough that the rhexis edge overlaps the IOL optic 360 degrees, reducing posterior capsular opacification.

9What is the purpose of hydrodissection during cataract surgery?

A.To stain the anterior capsule

B.To separate the lens nucleus from the surrounding cortex and capsule

C.To remove the IOL

D.To reduce IOP

Explanation: Hydrodissection injects BSS between the lens nucleus and cortex to separate them, allowing the nucleus to rotate freely within the capsular bag for safer phacoemulsification.

10What does FLACS stand for?

A.Foldable Lens Anterior Chamber System

B.Femtosecond Laser-Assisted Cataract Surgery

C.Flat Anterior Capsule Surgery

D.Foldable Lens Aspiration Cleansing System

Explanation: FLACS stands for Femtosecond Laser-Assisted Cataract Surgery, in which a femtosecond laser performs corneal incisions, capsulorhexis, and lens fragmentation prior to phacoemulsification.

About the OSA Exam

IJCAHPO specialty credential for ophthalmic surgical assistants — operating room scrub/circulating role for cataract, glaucoma, retinal, oculoplastic, and strabismus surgery. 80-MCQ Pearson VUE exam covering surgical procedures, instrumentation (phaco machine, microscope, IOL injectors, vitrectomy probes), sterilization/asepsis, perioperative patient care, OR safety (fire risk with O2 + cautery, time-out), and surgical pharmacology (viscoelastics, trypan blue, Miochol, intracameral antibiotics).

Questions

80 scored questions

Time Limit

Per IJCAHPO

Passing Score

Scaled (IJCAHPO-set)

Exam Fee

~$295-425 (IJCAHPO via Pearson VUE)

OSA Exam Content Outline

25%

Surgical Procedures

Phaco + IOL, vitrectomy, trabeculectomy, MIGS, strabismus, oculoplastics

20%

Instrumentation

Phaco machine, microscope, instruments (Utrata, McPherson), IOL injectors, vitrectomy probes

15%

Sterilization & Asepsis

Autoclave, IUSS, biological indicators, sterile draping, gowning, povidone prep

15%

Surgical Pharmacology

Viscoelastics (cohesive vs dispersive), trypan blue, Miochol, Toradol, intracameral cefuroxime

15%

Perioperative Patient Care

Pre-op evaluation, dilation, anesthesia (topical, sub-Tenon's), positioning, post-op

10%

OR Safety

Fire safety (O2 + cautery), fall prevention, Joint Commission time-out, OSHA

How to Pass the OSA Exam

What You Need to Know

Passing score: Scaled (IJCAHPO-set)
Exam length: 80 questions
Time limit: Per IJCAHPO
Exam fee: ~$295-425

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

OSA Study Tips from Top Performers

1Master 5% povidone-iodine prep (3 min before incision) + intracameral cefuroxime (ESCRS) for endophthalmitis prevention

2Memorize gas tamponade rules: NO N2O anesthesia + NO air travel for duration of bubble (SF6 ~10d, C3F8 ~6-8 wks)

3Drill Joint Commission time-out: site marking, verbal verification, antibiotic, equipment, all team participates

4Know OR fire triangle: O2 + heat (cautery/laser) + fuel (drape) — minimize O2 under drape, use room air

5Apply viscoelastic cohesive (Healon) to maintain space vs dispersive (Viscoat) to coat endothelium

Frequently Asked Questions

What is the gold standard for endophthalmitis prevention?

Pre-operative 5% povidone-iodine (Betadine) instilled in the conjunctival cul-de-sac — the only intervention with strong evidence to reduce post-cataract endophthalmitis. Apply at least 3 minutes before surgical incision. ESCRS Endophthalmitis Study (2007) added intracameral cefuroxime (1 mg in 0.1 mL at end of surgery) — reduces endophthalmitis by ~80%; intracameral moxifloxacin is an alternative. Topical antibiotics 4× daily for 1 week post-op.

What gas tamponades are used for retinal surgery?

Pars plana vitrectomy gas tamponades: SF6 (sulfur hexafluoride — short acting, ~10 days, expands ~2× normal volume); C2F6 (perfluoroethane — intermediate, ~2-3 weeks); C3F8 (perfluoropropane — long-acting, ~6-8 weeks, expands 4× normal volume). Critical patient instructions after gas: NO N2O ANESTHESIA (gas expands → catastrophic IOP rise) for duration of bubble; NO AIR TRAVEL (atmospheric pressure decrease → bubble expansion → IOP rise). Patient wears bracelet identifying gas. Position face-down for inferior holes.

What is the time-out before incision?

Joint Commission Universal Protocol (2004) — required pre-procedure verification: surgical site marking by surgeon (right vs left eye), time-out conducted by surgical team in OR with everyone stopping and verbally confirming: patient identity, procedure, surgical site (e.g., "left eye, cataract surgery, IOL +21.5"), allergies, antibiotic administration, equipment availability, anticipated blood loss/duration. Wrong-site surgery is a sentinel event — wrong-eye surgery has been a high-profile target.

How should I study for IJCAHPO OSA?

Plan 40-80 hours over 6-8 weeks. Focus weighted study on Surgical Procedures (25%) and Instrumentation (20%) — together 45% of exam. Master phacoemulsification workflow + IOL types, povidone-iodine + intracameral antibiotic prophylaxis, vitrectomy gas tamponade rules (NO N2O, no air travel), Joint Commission time-out, and OR fire safety (O2 + cautery under drape). Hands-on OR experience reinforces written content.