Each November, as we all begin to take stock of the year that’s winding down, Review of Optometry surveys its readers on their anticipated financial performance over the previous 12 months. In the aggregate, optometry is doing great: posting average annual incomes just shy of $200,000 per doctor. However, if you split the group in any meaningful way—employed vs. self-employed, young vs. old, men vs. women—you reveal a wide range of earnings, and they don’t always track with what one might consider a fair outcome.

“I feel optometrists are not paid as well as we should be compared to other doctors,” wrote one OD from the Mid-Atlantic region, who practices in a commercial setting. “I had a lot of debt and did not feel my salary (especially starting out) was enough to compensate. Perhaps school overall is too much, considering what we make on the outside. Plus, I’ve had to increase patients per hour to help with income.” 

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Even though the average income among this year’s pool of 422 respondents—an impressive $194,928—is virtually identical to last year’s, the data in our annual survey continues to highlight the greater opportunities afforded by private practice. Senior ODs also typically earn more than younger ones, even though that’s not always an accurate reflection of effort or expertise. Plenty of bright young optometrists are in the “paying their dues” phase of their careers right now.

“It’s my first year practicing and I have what I would think is a great salary, but I haven’t even started paying student loans ($230K) and my cost of living is quite high,” wrote one young OD. “Rent prices are insane. I’m worried for my financial future/retirement.”

Geographic area can swing the numbers notably too, with the lowest and highest regions adjacent to each other. And, most frustratingly, the gender divide continues to persist—even when accounting for part-time status.

As always, be mindful that while we ask the same survey questions, the responses come from different individuals each year, making trend analysis tricky. The results here offer an illuminating look at the profession but aren’t considered statistically rigorous, particularly in year-over-year comparisons.

With that caveat in mind, let’s dig in.

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Profits for Private Practitioners

Self-employed ODs who responded to our survey reported average earnings of $243,650 in 2024, while those in an employed setting received salaries of $156,819 on average, representing a 55% advantage for those who take the plunge into entrepreneurship. 

But, of course, higher earnings also add more stress to maintain the practice and one’s income level. 

“I’m very worried about increasing cost of goods and decreasing reimbursements for my practice (as well as increasing cost of living), as I won’t always be able to just ‘work more hours’ to balance out the books and maintain personal health and enjoyment,” wrote one reader from the Northeast.

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“I spend a great deal of time trying to maintain a high volume of patient visits and to maintain an excellent level of quality care,” wrote Brian Kahn, OD, who practices in the South. “I have learned from ophthalmology how to obtain this level of productivity and net income.”

The grind can easily lead to burn-out. “The net income is excellent, though I am seeking partnership since it’s a lot of work to get this income—it wears me out,” a self-employed OD from the West wrote. Some point to lifestyle choices they’ve made as decisive factors. “I am happy with the income because my husband and I chose not to have children,” wrote a solo private practitioner from the Northeast. “Otherwise, I’d be quite stressed by the rather poor daily life-work balance that I have.”

Savvy ODs know how to work the advantages of self-employment to their advantage.  “I’m currently purchasing the commercial real estate where I practice to build equity with payments instead of losing it to rent,” said reader Connor Smallwood, OD. Still, self-employment is an uphill climb. “I went from being employed to self-employed in a new state, and it’s slower than I thought it would be,” writes a solo private practitioner from the West. “I’m going to work part-time for another practice until mine builds up.”

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Employed ODs take comfort in having a steady paycheck and no entrepreneurial hassles, but are at the mercy of their practice owners. “I work way too hard for very little compensation,” said one employed OD. “My employer asks us to make sacrifices for the good of the business. I work 60 to 80 hours a week right now. I don’t have any spare time to work any additional jobs to increase my revenue.” This was echoed by many readers who expressed frustration at being squeezed by inflation on one end and stagnant paychecks on the other.

Turning to seniority, we see that well-established optometrists earned at least $50,000 more on average than younger ones, as those with 31+ years on the job reported income of $230,238 vs. $176,857 among ODs who’ve been in the workforce for 10 years or less.

The proportion of respondents who work part-time has been going up steadily. In 2018, just 9% of readers worked part time; this year, 15% do. Average earning within these groups were $204,523 among full-timers and $137,364 for part-time workers.

Women were twice as likely as men to report part-time employment status, and, as expected, this shows up in the disparity in earnings between the genders: $226,776 for men and $165,278 for women on average. However, even among readers of the same employment status, women earned less: female full-time ODs reported incomes of $179,039; among male ODs, it was $228,492.

Another factor at work: The women ODs in our survey also skewed younger than the men, and higher earnings accrue later in one’s career. The “years in practice” percentage breakdown by gender was as follows:

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One last piece of the puzzle: The breakdown of the self-employment category decisively favored male ODs, who comprised 59% of the group. Since earnings correlate with both self-employment and years in practice—and those categories remain dominated by men—the earnings of female optometrists continue to lag behind. In time, we expect a narrowing of this gap as the workforce continues to shift to a predominantly female one over time.

Stresses and Satisfactions

In the aggregate, nearly 15% of readers reported a decline in income in 2024 vs. 2023—never a welcome sight—and another 36% told us their incomes stayed the same, which is also dispiriting to many. “As a corporate sublease owner, the opening of all these other corporate locations has been horrible for business,” wrote one self-employed OD.  “My goal was to work very hard for a few years, save a lot and then leave. Now I’m working there longer because other jobs still don’t pay as much, and I’m not making as much as before.”

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Besides competition, ODs also have to constantly battle an insurance landscape that’s not conducive to their financial success or professional aspirations. “Frequently, patients change medical insurances and that prevents ODs from practicing medical optometry,” noted Spencer Moy, OD, a solo private practitioner from the Northeast. “Essentially, the only entry to care is an eyeglass plan. I refuse the play that game.” Performing what amounts to a medical exam on the scale of a vision exam’s compensation structure is a source of ire for many. “The most frustrating thing is that you have to do a diabetic exam with a vision plan that pays $35 dollars,” a Southern OD wrote. “Vision insurance should just be for refraction.”

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Macroeconomic forces also took a toll, as readers whose incomes declined ranked inflation the #1 factor contributing to it—and of course there’s the double-whammy of having to weather rising costs for one’s professional inventories but also personal expenses, too. “I’m still making the same as I was seven years ago, but inflation has made that money useless,” lamented one private practitioner from the Northeast.

Still, amid these often-difficult circumstances for many, there’s a deep well of satisfaction with what the practice of optometry provides; only 18% of respondents said they are dissatisfied with their compensation.

“I chose to work in a practice setting that allows me to put patients first,” one survey respondent wrote. “I did not select this job for best income.” Said another, “I feel like if I wanted to earn more I could, but currently I like my work-life balance.”

One optometrist whose income dropped in 2024 nevertheless reported that he was “very satisfied” with his income.  “I dumped all discount vision plans, reduced my workload to 3.5 days a week and now my associates work a little more,” he wrote.

As one reader put it, “I can make enough to help support my family doing a job I love.” Sometimes, it’s as simple as that.