The Eye Care Center Health Technicians in the Veterans Health Administration (VHA), VA Greater Los Angeles Health Care System, Surgical & Perioperative Care- Eye Care Center supports Ophthalmologists and Optometrists in diagnosis, treatment, prevention, follow-up care and patient counseling. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Certification: All applicants must be certified as a Certified Ophthalmic Assistant (COA) with the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). The COA certification is JCAHPO's entry-level certification examination for a Health Technician (Ophthalmology). Exception: Non-certified applicants who otherwise meet the minimum qualification requirements may be appointed as a graduate Health Technician (Ophthalmology) under the authority of 38 U.S.C. 7405(c)(2)(B). The appointing official may waive the requirement of certification for a period not to exceed two years for a Health Technician (Ophthalmology) that provides care under the supervision of an Ophthalmologist. The exception only applied below the full performance level. For grade levels at or above the full performance level, the candidate must be certified. Failure to obtain COA certification during that period is justification for termination of the temporary appointment and may result in termination of employment. Grade Determinations: GS-05 (Entry Level):One year of specialized experience (equivalent to at least the GS-04 level or pay band in the Federal service) that includes performing the following duties: performs limited routine assignments under daily direct supervision. Deviations from unanticipated problems and unfamiliar situations are referred to the supervisor for a decision or help. Obtains & records vital signs including blood pressure, pulse, and glucose levels. Participates in performance of quality assurance activities such as staff meetings, mandatory educational in-services, quality control reports, systems redesign, & team & morale improvement. GS-06: One year of specialized experience (equivalent to at least the GS-05 level or pay band in the Federal service) that includes performing the following duties: operates and monitors commonly used equipment performing basic screening procedures. Assists ophthalmology staff by obtaining an accurate medical & ophthalmic history, measuring & recording visual acuity, administering anesthetic eye drops, performing basic tonometry, estimating the anterior chamber depth & recording a simple spectacle reading through automated lensometry. Deviations from regular procedures, unanticipated problems, complex patients and unfamiliar situations are referred to the supervisor for a decision or assistance. Some assignments at this level also include developmental duties involving more complex procedures performed under supervision. GS-07: One year of specialized experience (equivalent to at least the GS-06 level or pay band in the Federal service) that includes performing the following duties: triages patient phone calls or requests; ensures exam rooms are stocked with adequate supplies; instructs patients on administration of eye drops & post-operative instructions; accurately measures, compares, & evaluates pupillary responses; administers eye drops to dilate pupils; performs basic color vision screening; performs visual field testing (using Amsler grid or automated equipment). Performs basic imaging testing such as corneal topography; external photography; performs basic ocular testing such as pachymetry, tear production with test strips, glare testing, stereo acuity, contrast sensitivity, potential acuity meter, measuring spectacles using both automated & manual lensometry & transposing cylinders. The employee assists the ophthalmologist during minor ophthalmic surgical procedures & is adept at applying sterile technique & infection control procedures. Performs autorefractor to determine spectacle prescription. GS-08: One year of specialized experience (equivalent to at least the GS-07 level or pay band in the Federal service) that includes performing the following duties: a range of standard, but complex, diagnostic procedures with responsibility for checking calibration of instruments prior to the procedure. Responsible for obtaining patient physical history, to include chief complaint; reason for visit; pertinent signs/symptoms; past history both ocular and general; family history both ocular & general; social history; and review of medications and allergies, including current ocular prescription & non-prescription medications. Accurately tests visual acuity at distance and near, with & without correction or with & without a pinhole. Measures eyeglass prescription using manual or automated lensometer, recording sphere, cylinder, axis, and prism in both plus & minus cylinder. Performs pupil evaluation recording pupil size, shape, symmetry, reaction to light & accommodation, & any abnormalities, including relative afferent pupillary defect. Performs basic refractometry utilizing an auto refraction or habitual glass prescription in the phoropter. Instills eye medications (i.e., drops or ointments, including anesthetic, dye, dilation, cycloplegic, or antibiotics. Responsible for measuring intraocular pressure of the eye utilizing techniques, including Goldmann applanation tonometry. Performs pachymetry to determine corneal thickness & manual keratometry or automated topography to determine corneal curvature. Performs intra-ocular lens calculations using the IOL Master. Performs automated visual field testing using various perimetry machines. Performance of external photographs & fundus photography. Performs optical coherence tomography (OCT) of the anterior segment, retina & optic nerve. Performs patient screening & triage emergencies identifying ocular emergencies. Performs patient screening & telephone triage for immediate care. Assists during clinic-based ophthalmic surgery, including revision of wounds, biopsies of the eyelid lesions, cultures of conjunctiva, or cornea; reformation of anterior chamber, evacuation of hyphema, repositioning of corneal endothelial grafts, intra-vitreous injections, & laser surgical procedures. Educates patients & legal authorized representatives in eye care, including preoperative & postoperative instructions. Assists in the education & training of medical students, residents & fellows in those facilities with medical school affiliations. Ensures proper cleaning & disinfection; calibration, maintenance, backup, annual inventory & ordering of instruments, supplies & equipment; obtains quotes as needed; & reports needed repairs to biomedical engineering. References: VA Handbook 5005, Part II, Appendix G52The full performance level of this vacancy is GS-08. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-05 to GS-08. ["The Full Performance GS-8 Health Technician performs a range of standard, but complex, diagnostic procedures, assists during clinic-based surgical procedures, educates patients and legal representatives, assists with the education of medical students and residents. The Full Performance Health Technician may perform many \"direct patient care services\" including, but not limited to basic imaging testing such as corneal topography; external photography; performs basicocular testing such as pachymetry, tear production with test strips, glare testing, stereo acuity, contrast sensitivity, potential acuity meter, measuring spectacles using both automated and manual lensometry and transposing cylinders. The employee assists the ophthalmologist during minor ophthalmic surgical procedures and is adept at applying sterile technique and infection control procedures. Performs autorefractor to determine spectacle prescription under the guidance of the Ophthalmologist or Optometrist. Work Schedule: Monday through Friday, 8:00am-4:30pm or 8:30am-5:00pm Telework: Not Available Virtual: This is not a virtual position. Position Title/Functional Statement #:Health Tech(Ophthalmolgy)/PD000000 Relocation/Recruitment Incentives: Not available Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required Physical Requirements: Lifting, pushing, pulling of up to 35 lbs. Pushing for up to 1-2 hours intermittently. Continuous use of computer for 2-4 hours including use of keyboard and mouse. Prolonged repeated wrist movement using equipment. Reaching above shoulder required. Ability to hear people speaking and to be able to answer the phone. Manual dexterity ability. Ability for rapid metal and muscular coordination simultaneously required. Newar vision correctable in one eye to 20/20 and to 20/40 in the other. Requires use of both hands. Requires use of both legs or alternate mode of mobility (i.e. wheelchair). Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level."]

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