- What This Cheat Sheet Covers (and What It Doesn't)
- The Exam at a Glance
- The Ten-Domain Weight Map
- Heavy Hitters: Fluorescein Angiography and Fundus Photography
- Supporting Domains: Anatomy, General Photography, Safety, Data
- Small Domains That Still Cost Points
- Eligibility, Fees and Application Mechanics
- Test-Day Rules and Score Reporting
- Recertification Quick Reference
- A Domain-Weighted Review Sequence
- Conflicting Information You Will Encounter
- Frequently Asked Questions
- The exam has 175 four-choice multiple-choice questions and a two-hour limit, delivered at Prometric test centers.
- Fluorescein Angiography (25%) and Fundus Photography (23%) together make up 48% of the published content weights.
- Initial fee is $465 for OPS members and $590 for non-members; a retest costs $285.
- Eligibility requires an accepted imaging portfolio, two years of verified angiography experience, and current CPR.
What This Cheat Sheet Covers (and What It Doesn't)
The Certified Retinal Angiographer credential is issued by the Ophthalmic Photographers' Society (OPS) Board of Certification. This page condenses the facts that matter most into one scannable reference: exam format, domain weights, fee mechanics, test-day rules, and renewal requirements. Every number below comes from the OPS CRA Program Guide (version 15.1, effective June 2026), the controlling public document for the exam.
If you want depth on any single topic, this article points you to the longer guides on this site. For a full preparation plan, start with the CRA study guide for passing on your first attempt. For a content-area deep dive, see the complete guide to all 10 CRA content areas. And when you are ready to test your recall under realistic conditions, the CRA practice test is the fastest way to find out where your gaps are.
The Exam at a Glance
| Item | What the 2026 Program Guide Says |
|---|---|
| Certifying body | Ophthalmic Photographers' Society, Board of Certification |
| Delivery | Computer-based, at Prometric test centers |
| Question count | 175 multiple-choice questions |
| Answer format | Four choices, one correct or best answer |
| Time limit | Two hours |
| Scored vs. unscored items | Not separately disclosed |
| Scoring model | Criterion-referenced, Modified Angoff V competency standard, scaled reporting |
| Numeric cut score | Not publicly verified |
| Penalty for wrong answers | None beyond receiving no credit; blank answers also earn no credit |
| Reference materials | Closed book |
Two things stand out. First, 175 questions in 120 minutes leaves you under 41 seconds per item on average, so pacing matters. Second, because there is no penalty beyond losing credit, you should answer every question, including the ones you are unsure about. Leaving a blank is never better than a reasoned guess.
The published passing standard is criterion-referenced. That means you are measured against a competency standard, not against other candidates. For a closer look at how scaled reporting works and what is and is not known about the cut score, read CRA passing score: exactly what you need to pass.
The Ten-Domain Weight Map
The ten weighted content areas are official exam objectives based on the 2017 job analysis. They are not optional background reading. Published weights sum to 100%.
| # | Domain | Weight |
|---|---|---|
| 1 | Applies the Principles of the Anatomy, Physiology, and Pathology of the Eye | 16% |
| 2 | Patient Management and Patient/Operator Safety | 6% |
| 3 | General Photography | 10% |
| 4 | Data and Image Management | 4% |
| 5 | Fundus Photography - Fundus Camera and Scanning Laser Ophthalmoscope | 23% |
| 6 | Monochromatic Imaging and Fundus Autofluorescence | 5% |
| 7 | Fluorescein Angiography with Fundus Camera or Scanning Laser Ophthalmoscope | 25% |
| 8 | Indocyanine Green (ICG) Angiography | 3% |
| 9 | Pharmacology | 5% |
| 10 | Other Imaging Technology | 3% |
A quick way to remember the shape of the exam: two domains carry nearly half the weight (48%), one mid-sized domain (Anatomy, Physiology and Pathology at 16%) carries about one-sixth, and the remaining seven domains split the rest. Domains 8 and 10 are each only 3%, but they still appear on the test and are often where well-prepared candidates drop avoidable points.
Heavy Hitters: Fluorescein Angiography and Fundus Photography
Domain 7: Fluorescein Angiography (25%)
Fluorescein Angiography with Fundus Camera or Scanning Laser Ophthalmoscope
The single largest domain. Expect questions on the full procedural arc, from patient preparation through image interpretation, on both camera-based and scanning laser platforms.
- Phases of the angiogram and what normal timing looks like in each phase
- Patient preparation, dye injection technique, and timing the start of capture
- Filter selection and the excitation and barrier filter relationship
- Recognizing hyperfluorescence and hypofluorescence patterns and what causes them
- Image artifacts, pseudofluorescence, and how to correct technique in real time
- Adverse reactions to the dye and the operator's response
This domain rewards candidates who have performed angiograms, not just read about them. Questions often present a scenario (an image with a problem, or a patient situation mid-procedure) and ask for the best next action. Practice reasoning from cause to effect rather than memorizing isolated definitions.
Domain 5: Fundus Photography (23%)
Fundus Photography - Fundus Camera and Scanning Laser Ophthalmoscope
The second-largest domain and the foundation for everything else, since good angiograms depend on good fundus technique.
- Camera alignment, working distance, focus, and illumination controls
- Field-of-view choices and building montages and stereo pairs
- Troubleshooting common image-quality problems such as haze, flare, and uneven illumination
- Differences between fundus camera and scanning laser ophthalmoscope imaging
- Handling small pupils, media opacities, and difficult patients
Together these two domains account for 48% of the published weights, so any review plan that does not front-load them is misallocating time. For more on how difficult candidates typically find this content, see how hard the CRA exam is.
Key Takeaway
If you can only master two areas thoroughly, make them Fluorescein Angiography and Fundus Photography. Nearly half of every exam form draws from these two domains, and solid command of them also supports your performance in Domains 1, 6 and 8.
Supporting Domains: Anatomy, General Photography, Safety, Data
Domain 1: Anatomy, Physiology, and Pathology of the Eye (16%)
This is where clinical knowledge meets imaging. You need enough anatomy to name structures visible on a fundus image, enough physiology to explain why dye behaves as it does in the retinal and choroidal circulations, and enough pathology to recognize what common retinal conditions look like in each imaging modality. Think of it as the interpretive layer that makes Domains 5 and 7 meaningful. Candidates who skip pathology often struggle when an angiography question is framed around a disease presentation.
Domain 3: General Photography (10%)
Optics and photographic fundamentals: exposure, light, color, resolution, and the principles that apply to any imaging system. These questions can feel less specific to retinal work, but they underpin the fundus camera behaviors tested in Domain 5. Review how sensor characteristics, illumination, and filters affect image quality.
Domain 2: Patient Management and Patient/Operator Safety (6%)
Communication, consent, positioning, infection control, and emergency readiness. Small by weight, but these items tend to be answerable with careful reasoning. Know the operator's responsibilities if a patient has a reaction during dye injection.
Domain 4: Data and Image Management (4%)
Image storage, file handling, patient identification, and records integrity. Expect practical questions about keeping images correctly associated with the right patient and eye.
Small Domains That Still Cost Points
Four content areas together make up 16% of the exam. Candidates often under-study them because each looks small, but that adds up to roughly 28 questions on a 175-item test, assuming the weights map proportionally to question counts.
Domain 6: Monochromatic Imaging and Fundus Autofluorescence (5%)
Know what each technique reveals that standard color photography does not, and what wavelengths and filters are involved.
- Red-free and other monochromatic imaging purposes
- What autofluorescence signals represent
- When these modalities are chosen instead of, or alongside, angiography
Domain 9: Pharmacology (5%)
Dilating agents, the fluorescein and ICG dyes themselves, and responses to adverse events.
- Common mydriatic agents and relevant cautions
- Dye characteristics, side effects, and contraindications
- Recognizing and responding to reactions of varying severity
Domain 8: Indocyanine Green (ICG) Angiography (3%)
Know how ICG differs from fluorescein: what it visualizes, why its wavelength properties matter, and when it is preferred.
Domain 10: Other Imaging Technology (3%)
Breadth questions on imaging modalities beyond the core fundus and angiography techniques. Review what each technology shows and its basic principles.
A smart tactic for these low-weight areas: study them for contrast, not depth. Ask "how does this differ from fluorescein angiography?" and you will cover most of what a question is likely to test.
Eligibility, Fees and Application Mechanics
Who Can Apply
Eligibility has several parts, and all must be satisfied before you can sit for the exam:
- Imaging portfolio: an accepted applicant-produced portfolio of your own work.
- Experience: verification from your employing physician or institution of two years of retinal-angiography experience.
- CPR: current CPR, including a current in-person skills assessment.
Specified education or professional credentials can substitute for up to one year of the experience requirement. Candidates still working toward the experience requirement may pursue Provisional CRA status, which is a distinct designation. No mandatory OPS preparation course or universal training-hour total is verified. For the full breakdown, see CRA requirements: eligibility, prerequisites and how to qualify.
Fee Table
| Fee | Amount | Notes |
|---|---|---|
| Initial exam, OPS member | $465 | Includes the $50 non-refundable application component |
| Initial exam, non-member | $590 | Includes optional one-year OPS membership and the $50 application component |
| Retest | $285 | For repeat attempts |
| Renewal, OPS member | $100 | Three-year cycle |
| Renewal, non-member | $225 | Three-year cycle |
Timeline
Submit your application and portfolio at least eight weeks before your desired exam date. The portfolio review is a gate, not a formality, so build in buffer time for any revisions. Scheduling windows and deadlines are covered in CRA exam dates: testing windows, deadlines and scheduling.
Test-Day Rules and Score Reporting
- Identification: bring valid government-issued photo ID.
- Materials: closed book. Outside references, personal calculators and electronics are prohibited.
- Supplies: scratch paper and a pencil are provided.
- Answering: no guessing penalty beyond incorrect or blank answers earning no credit, so answer everything.
- Delivery format: Prometric test center. No current remote or adaptive delivery option is verified.
- Accommodations: follow the published OPS accommodation process.
What Your Results Look Like
Passing candidates receive a pass notice without a numeric score. Candidates who do not pass receive a scaled score and a diagnostic content-area report, which is genuinely useful for targeting a retake. Initial score reports are provisional pending a 72-hour statistical verification, and the guide allows for reporting delays during exam-development cycles.
There is no verified current pass rate. Historical OPS Board of Certification reports show 537 passes among 857 candidates tested (63%) from April 1997 through July 2018, but that is a long-run historical figure, not a current first-attempt rate. For a careful reading of what the available data can and cannot tell you, see CRA pass rate: what the data shows.
Recertification Quick Reference
| Element | Requirement |
|---|---|
| Cycle length | Three years, starting January 1 of the year after certification is earned |
| Credits needed | 15 CECs earned during the cycle |
| OPS-specific minimum | At least five CECs from official OPS or OPS BOC pre-approved courses or workshops |
| Category caps | Teaching, eligible non-OPS-approved attendance, and publication categories capped at ten credits each |
| Non-OPS attendance rate | 0.5 CEC per hour |
| Renewal fee | $100 member / $225 non-member |
| Alternative route | Retake the exam by the end of year three; pay the exam fee with no additional recertification fee |
The practical implication: plan your continuing education early in the cycle, because the five-credit OPS minimum cannot be met with generic non-OPS courses. If you attend outside education at 0.5 CEC per hour, you need a lot of hours to approach the 15-credit total, so favor OPS-approved offerings where possible.
A Domain-Weighted Review Sequence
Rather than a generic schedule, allocate your calendar in proportion to exam weight and to dependency between domains. The sequence below assumes about six weeks and is meant as a template to adapt to your own strengths.
Foundations: Domains 1 and 3
- Anatomy, physiology and common retinal pathology (16% of the exam)
- Photographic optics and exposure principles (10%)
Fundus Photography: Domain 5
- Camera operation, troubleshooting, and scanning laser ophthalmoscope differences
- Take a timed block of practice questions at the end of week 3
Fluorescein Angiography: Domain 7
- Phases, timing, filters, and interpretation of fluorescence patterns
- Artifact recognition and adverse-reaction responses
Contrast Domains: 6, 8, 9, 10
- Autofluorescence, ICG, pharmacology, and other imaging technology
- Study each by comparing it with fluorescein angiography
Safety, Data and Full-Length Practice
- Patient management, safety, and image management (Domains 2 and 4)
- At least one full 175-question simulation in a two-hour sitting using the CRA practice test
The logic: anatomy and photographic principles come first because they feed into everything else. The two heavy domains get the most calendar time. Low-weight domains are batched and studied by comparison. The final week is for pacing practice, since 175 questions in two hours is a real endurance test. For a broader treatment of preparation, including how to schedule around a full-time clinical job, return to the CRA study guide.
Conflicting Information You Will Encounter
OPS maintains several web pages, and not all are in sync with the June 2026 Program Guide. When sources disagree, treat the 2026 guide as controlling and confirm anything that affects your timeline or budget directly with OPS.
Also be cautious with older fee listings. One older category page shows a $200 non-member renewal amount, but current individual product pages show $225, which is the figure used in this article. If you are weighing the whole investment, the ROI analysis for the CRA certification and the CRA salary guide put these costs in a career context, and CRA jobs covers the kinds of employers that value the credential.
Frequently Asked Questions
The written exam has 175 multiple-choice questions, each with four choices and one correct or best answer, and a two-hour time limit. The number of scored versus unscored questions is not separately disclosed.
Fluorescein Angiography is the largest at 25%, followed by Fundus Photography at 23%, together 48% of the weights. Anatomy, Physiology, and Pathology of the Eye is next at 16%, and General Photography follows at 10%.
The initial fee is $465 for OPS members and $590 for non-members, with the non-member price including one year of optional OPS membership. The $50 non-refundable application component is included in those totals. A retest costs $285.
No. The exam is closed book, and outside references, personal calculators and electronics are prohibited. Scratch paper and a pencil are supplied, and you must present valid government photo ID.
Certification runs on three-year cycles. You need 15 CECs earned during the cycle, including at least five from official OPS or OPS BOC pre-approved courses or workshops, or you can retake the exam by the end of year three. Renewal costs $100 for members and $225 for non-members.
Use this cheat sheet as a quick-reference anchor, then dig into the linked guides for the areas where you feel least confident. If you want a refresher on the credential itself before going deeper, start with what CRA certification is, and keep this page bookmarked at the CRA cheat sheet for a final skim the night before your exam.