Optometrist Job Description

An optometrist is a primary eye care doctor. The visit that looks routine from the chair is a layered exam: the doctor measures the eye's optics to arrive at a prescription, checks how the two eyes work together, takes pressure readings, and then looks at the front and back of the eye for disease. A blurry-vision complaint can end with new glasses, a dry eye treatment plan, a glaucoma workup or a same-day referral to a retina surgeon.

The BLS lists the core work plainly: optometrists diagnose vision problems and eye diseases such as glaucoma, prescribe eyeglasses, contact lenses and other visual aids as permitted by state law, perform minor surgical procedures, and prescribe medications. That phrase about state law matters. Each state's optometry act defines what drugs an optometrist may prescribe and which procedures, if any, they may perform, so the same O.D. can have a broader or narrower practice after moving across a state line.

The exam room

The tools are standard across settings. A phoropter and retinoscope for refraction. A slit lamp for the lids, cornea, lens and anterior chamber. Tonometry for eye pressure. Dilated fundus exams, fundus photography and optical coherence tomography (OCT) for the retina, macula and optic nerve. Automated visual fields for glaucoma suspects. Technicians may run the pretesting and imaging; the optometrist reads the results, examines the patient and makes the call.

Medical eye care

Medical work includes chronic disease follow-up. Glaucoma patients return on a schedule for pressure checks, fields and OCT scans, and the optometrist adjusts topical drops or refers for laser or surgery. Patients with diabetes need retinal exams, with findings sent back to the primary care physician. Dry eye, allergic and infectious conditions, and corneal abrasions fill acute slots. BLS also notes that optometrists evaluate patients for other diseases and conditions, such as diabetes or high blood pressure, and refer them to other providers as needed.

Surgery co-management and specialty work

Optometrists provide pre- and postoperative care to patients undergoing eye surgery. In a typical co-management arrangement, the optometrist confirms a cataract is ready for surgery, the ophthalmologist operates, and the optometrist handles the post-op visits. Specialty niches include scleral and other medical contact lenses for irregular corneas, myopia control for children, pediatric and binocular vision care, vision therapy, and low-vision rehabilitation for patients with permanent sight loss.

Settings

BLS says most optometrists work in offices or in optical goods stores and usually work full time. An independent practice owner also runs a business: optical inventory, staff, vision plan and medical insurance contracts, and equipment purchases. An associate in a corporate or retail-affiliated office focuses on patient care on a set schedule. Hospital, VA and academic clinics place the optometrist inside a larger medical team, alongside ophthalmologists, primary care physicians and residents.

Education

The entry credential is the Doctor of Optometry (O.D.) degree from a program accredited by the Accreditation Council on Optometric Education (ACOE). BLS puts the program at 4 years of graduate-level study and says applicants must have completed at least 3 years of undergraduate education, though they typically hold a bachelor's degree. As a rough guide, applicants plan their undergraduate years around biology, chemistry, organic chemistry, physics, math and anatomy, and they spend time shadowing optometrists before applying.

The first half of an O.D. program is heavy on optics, ocular anatomy, physiology, pharmacology and pathology. The second half moves into clinics and external rotations, where students run patient exams under supervision in settings such as community health centers, VA clinics and specialty practices.

Board exams and licensure

Every state requires optometrists to be licensed. The National Board of Examiners in Optometry (NBEO) runs the entry-into-the-profession exams: the licensure exam (Part I ABS, Part II PAM/TMOD and Part III PEPS), plus the Injections Skill Exam (ISE) and the Laser & Surgical Procedures Exam (LSPE). A candidate's scores go to the state boards they select, and each board sets which NBEO parts it requires. License renewal and continuing education rules are set state by state.

Optometrists who prescribe controlled substances, where their state allows it, also register with the U.S. Drug Enforcement Administration.

Residency and certification

A residency is optional. The VA's Optometry Service offers student externships, post-doctoral residency education and post-residency fellowships, and all of its residents train in primary eye care and ocular disease management. As a rough guide, residencies run one year and focus on areas such as ocular disease, primary care, cornea and contact lenses, pediatrics and binocular vision, or low vision.

Later credentials include board certification from the American Board of Optometry and Fellowship in the American Academy of Optometry (FAAO).

Skills that matter on the job

• Refraction, including cycloplegic refraction for children
• Slit lamp and dilated fundus examination
• Reading OCT scans, visual fields and fundus photos
• Contact lens fitting, from routine soft lenses to sclerals
• Medical management: drop selection, follow-up intervals and referral thresholds
• Writing clear reports to primary care physicians and surgeons
• Explaining a diagnosis in plain language to a worried patient

For practice owners, add vision plan and medical billing, optical retail management and staff hiring. A new graduate who wants to own a practice can start as an associate and buy in later.

BLS projects employment of optometrists to grow 10 percent from 2025 to 2035, which it rates as much faster than the average for all occupations. That works out to an employment change of 4,300 jobs, and BLS expects about 2,000 openings for optometrists each year, on average, over the decade. Many of those openings are expected to come from replacing optometrists who change occupations or leave the labor force, for example to retire. The demand driver BLS names is age: vision problems tend to occur more frequently later in life, so an aging population will lead to demand for optometrists.

Pay by setting

The national band mixes settings with different medians. In May 2025 OEWS data, optometrists in offices of optometrists had a median of $129,250. Those employed in offices of physicians, a category that covers ophthalmology practices, had a median of $145,630. BLS does not split those figures by role, so the numbers do not show whether the gap comes from duties, hours, ownership or location.

Scope of practice keeps moving

The National Conference of State Legislatures' tracker shows how wide the range is: some states limit optometrists to examination, diagnosis and treatment, while others grant surgical or laser privileges. In June 2026, Vermont's governor signed a bill expanding optometric practice; the Vermont Optometric Association says it made Vermont the 17th state to authorize doctors of optometry to perform in-office procedures, including ophthalmic laser procedures, and the third state in 2026 to achieve a major scope advancement. Under that law, starting July 1, 2028, Vermont optometrists who complete the required specialty license may perform laser capsulotomy, laser peripheral iridotomy, laser trabeculoplasty and corneal cross-linking, among other procedures. For a new graduate, the state you license in can shape what your clinic day contains.

AI and diabetic eye screening

One part of the eye exam AI has reached is diabetic retinopathy screening. The 2026 version of the CMS electronic quality measure Diabetes: Eye Exam (CMS131v14), stewarded by the National Committee for Quality Assurance, counts an exam by an ophthalmologist or optometrist, or fundus photography results analyzed by a system that provides an autonomous artificial intelligence calculation. Under the measure, an autonomous AI read of fundus photos counts the same as an eye exam by an ophthalmologist or optometrist. The software screens for one disease; refraction, lens fitting, glaucoma care and the treatment of retinopathy found on screening remain clinical work for eye doctors.

Myopia control

Eye drops are the other open question in myopia control. As of a Nov. 3, 2026 MedPage Today report, an FDA advisory committee did not vote to recommend for or against approval of SYD-101, a low-dose atropine eye drop, and its regulatory status remained unresolved.

What to weigh

New O.D.s choose between independent, corporate, physician-practice, hospital and VA paths. Each differs in schedule, patient mix and ownership options, and the state license sets the procedure scope that comes with any of them.

Dear Dr. Okafor,

I am applying for the associate optometrist position at Riverbend Eye Associates. I will complete my Doctor of Optometry degree in May and have passed my national boards. My final-year rotations were at a community health center, a VA eye clinic and a private practice with a busy specialty contact lens service, and each one sharpened a different part of my exam.

At the VA clinic I carried a panel of glaucoma suspects and patients with diabetic retinopathy. I learned to read OCT nerve fiber scans and visual fields against the prior visit rather than in isolation, and to write referral letters that a retina surgeon could act on without calling me back. My preceptor trusted me to set follow-up intervals and adjust topical drops, with her sign-off.

The private practice rotation is where I found the work I want to build on. I helped fit scleral lenses for patients with keratoconus and post-surgical corneas, and I sat in on the practice's myopia control visits for children. Your practice's pediatric program is a large part of why I am applying. I would like to learn your protocols for patient selection and follow-up and eventually carry part of that schedule myself.

I am also comfortable with the business side of a clinic day. At the health center I worked with billing staff to code medical visits correctly, and I explained vision plan benefits to families who had never had an eye exam.

I want a practice where I can see the same patients over many years and grow my medical and specialty lens skills. I would welcome the chance to visit Riverbend, shadow a clinic day and talk about how I could contribute.

Sincerely,

Jordan Reyes