How to Open an Optometry Practice: Key Setup Checklist

Key Steps for Licensing, Equipment, Location, and Launch

An optometry practice is a health care clinic where a licensed optometrist examines eyes, checks vision, and writes prescriptions for glasses and contact lenses. Depending on your state’s scope of practice, you may also evaluate and manage certain eye conditions and refer patients to an ophthalmologist when needed.

Many optometry practices combine clinical care with an optical dispensary. That means patients can get their exam and then choose frames, lenses, or contacts in the same place.

How Does An Optometry Practice Generate Revenue

Optometry practices usually earn revenue from both clinical services and product sales. Your mix depends on whether you include an optical dispensary, accept insurance, and offer specialty services.

Before you open, decide what your “day one” revenue streams will be. You don’t need to offer everything at once.

Eye exams: routine vision exams and medical-focused evaluations (based on scope and payer rules)
Refractions: determining prescription strength for glasses
Contact lens services: fittings, follow-ups, and prescription renewals
Optical sales: frames, prescription lenses, and prescription sunglasses (if you dispense)
Contact lens sales: contacts and related accessories (rules vary by product and state)
Diagnostic testing: imaging and testing when medically appropriate and properly billed

Products And Services You Can Offer

Your service menu can be simple or wide, but it has to match your license scope, equipment, and setup. A new practice often starts with core services and expands after the workflow is stable.

If you’re not sure what to include first, start with what patients in your area need most and what you can deliver confidently.

Comprehensive eye exams: vision testing, refraction, eye health evaluation
Glasses prescriptions: including updated measurements for vision correction
Contact lens fittings: standard soft contacts and follow-up visits
Contact lens training: insertion and removal coaching for new users
Eye health evaluations: within your state scope, with referrals when needed
Optical dispensary services: frame selection, lens choices, adjustments (if offered)
Specialty options (as you grow): dry eye services, specialty lenses, myopia control programs (equipment and scope dependent)

Who Your Customers Are

Your patients can be anyone who needs vision correction, eye health checks, or contact lenses. The exact mix depends heavily on your location, nearby competitors, and which insurance plans you accept.

Think in real groups, not broad labels. Who’s already living and working near your clinic?

Working adults: routine vision needs, screen-related complaints, updated prescriptions
Families with children: school-age vision checks and glasses needs
Older adults: ongoing monitoring and referrals when needed
Contact lens users: fitting, renewals, and comfort troubleshooting
Patients with medical concerns: evaluations within optometry scope, plus specialist referrals

Pros And Cons Of Starting An Optometry Practice

This can be a stable, long-term clinic business, but it’s not a casual startup. You’re building a licensed health care practice with specialized equipment and strict compliance rules.

Read both sides before you commit. It’ll save you stress later.

Pros: steady demand for vision care, multiple revenue streams, repeat patient relationships, ability to build a trusted local clinic
Cons: high equipment needs, credentialing and payer setup can take time, compliance requirements are non-negotiable, staffing and optical inventory can raise startup complexity

Is Starting An Optometry Practice Right For You?

Start with the big decision: do you truly want to own and operate a business, and is an optometry practice the right fit for you?

If you want a wider view of what ownership demands, read Points to Consider Before Starting Your Business.

Now let’s talk about pressure. Passion doesn’t replace planning, but it does matter. When problems hit—delays, paperwork, setbacks—passion helps you stay in the game and solve the problem instead of looking for an exit.

If you want a deeper look at that side of ownership, read Passion: An Important Key.

Here’s the motivation test you can’t skip. Ask yourself this exact question: “Are you moving toward something or running away from something?”

If you’re starting only to escape a job you hate or a financial bind, that energy may not last. This business asks for patience, consistency, and real follow-through.

Now get honest about responsibility. Are you ready for uncertain income at first, long hours, hard tasks, fewer vacations, and full responsibility when something breaks or goes wrong?

Is your family or support system on board with what this takes? And do you have the skills—or the ability to learn them—and the funds to start and operate until revenue becomes steady?

One smart move most new owners skip is learning from people already doing the work. Talk to optometry practice owners, but only if you won’t be competing with them.

That means you speak to owners in a different city, region, or area—only talk to owners you will not be competing against.

“What surprised you most in your first 90 days?”
“What would you do differently before opening day?”
“Which equipment or vendors mattered most early on?”

Before you go further, it also helps to see what owners deal with behind the scenes. You can get that perspective from Business Inside Look.

Step 1: Choose Your Practice Model And Your Role

Optometry is a licensed-care business. That means your startup starts with one basic question—who is providing the clinical care?

If you’re a licensed optometrist, you may be the owner and the provider. If you’re not, you’ll need a licensed optometrist in place to deliver patient care and meet state rules.

Next, choose your practice model. The model shapes staffing, equipment needs, space needs, and how complex your opening will be.

Clinical-only practice: exams and prescriptions, limited product sales
Clinic with optical dispensary: exams plus frames and lenses on-site
Contact lens-focused clinic: strong emphasis on fitting and follow-up care
Specialty-forward clinic: adds imaging and niche services as equipment allows

Now decide how you’ll run the ownership side. Will you operate solo, bring in partners, or involve investors?

This is also where you decide if it will be full-time or part-time. For most people, an optometry practice is a full-time build, especially in the first year.

Staffing choices matter early. You can do more tasks yourself at the start, but you can’t do everything alone forever.

You might handle early: vendor setup, basic scheduling systems, clinic layout planning, branding choices
You may hire early: front desk support, optical help (if dispensing), technician support (depending on services)

If you’re unsure where your strengths end, it helps to build a support bench. A good starting point is building a team of professional advisors so you’re not guessing on legal, tax, and setup decisions.

Step 2: Verify Demand In Your Area

Demand can look “obvious” and still be weak once you open. So you verify it before you sign a lease or buy equipment.

Your goal is simple—confirm enough people in your area will choose your practice consistently.

Start with local research. Pay attention to who already serves your area and how they position their services.

Search for independent optometry clinics nearby
Check large retail vision centers and optical chains
Look at ophthalmology groups that also offer routine eye care
Note office hours, appointment lead times, and service focus

Then narrow it down. What is underserved locally—family-friendly scheduling, contact lens help, evening appointments, certain insurance plans?

If you want a clear framework for this kind of analysis, see supply and demand basics and apply it to your city.

Step 3: Check If The Numbers Can Support You

Demand is not enough on its own. You also need profit ability—meaning the practice can cover expenses and still pay the owner.

This is where a lot of first-time owners get surprised, because health care startups have real fixed costs.

Start by listing your major cost buckets. Then get pricing estimates for each one so your plan is grounded in real numbers.

Lease and buildout costs (exam rooms, optical space, waiting area)
Clinical equipment and installation
Optical inventory (frames and lenses) if you dispense
Technology (electronic health record, scheduling, payment processing)
Professional services (legal, accounting, credentialing help if needed)
Staff pay and payroll setup (if hiring early)

Scale drives startup cost totals. A single-lane clinic is very different from a multi-provider clinic with imaging and a large optical floor.

If you want a structured way to build your estimate, use estimating startup costs as your checklist.

Pricing also matters early. Even if you’ll accept insurance, you still need to understand your service pricing and retail pricing structure.

A helpful reference point is pricing your products and services, then adapt it to clinical services and optical goods.

Step 4: Decide Your Services And Patient Flow

Before you open, define what you will offer on day one. Keep it tight so your setup stays realistic.

You can always expand later, but you can’t fake readiness on opening day.

Decide your initial services and how a patient moves through the visit.

Check-in and paperwork
Pre-test screening (if you offer it)
Doctor exam and refraction
Plan and prescription release
Optical selection and ordering (if you dispense)
Checkout and follow-up scheduling

This also helps you picture your day-to-day reality. You’ll review charts, run exams, finalize prescriptions, handle referrals, and complete documentation.

If you offer contacts, you’ll also fit lenses, coach new users, and manage follow-up visits.

Step 5: Build Your Essential Equipment List

This is where optometry becomes very different from many service businesses. Equipment is not optional, and the right setup depends on your service menu.

Build your list first. Then request pricing estimates and lead times so you can plan ordering and installation.

Exam Lane Essentials

Exam chair
Instrument stand or table
Doctor stool
Phoropter (manual or digital)
Visual acuity chart system (digital or wall chart)
Trial lens set and trial frames
Lensometer
Retinoscope
Direct ophthalmoscope
Slit lamp biomicroscope
Tonometer (intraocular pressure test)
Keratometer or autorefractor/keratometer
Near vision cards and fixation tools

Pre-Test And Screening Tools

Autorefractor/keratometer (if not in the lane)
Pupillary distance tools
Color vision testing materials
Stereo vision testing tools
Corneal pachymeter (if used)

Diagnostic Imaging (Common Add-Ons)

Fundus camera or retinal camera
Optical coherence tomography unit (if offered)
Visual field analyzer (perimetry)

Contact Lens Fitting Essentials

Contact lens trial sets
Specialty fitting sets (only if you plan to offer them)
Training tools for insertion and removal coaching
Hand mirrors and training materials

Optical Dispensary Setup (If You Dispense)

Frame display boards and merchandising fixtures
Frame inventory assortment
Dispensing mirrors
Pupillary distance measurement tools
Frame adjustment tools (screwdrivers, pliers, nose pad tools)
Frame heater or warmer
Lens sample tools for patient education
Point-of-sale system (if separate from your main system)

In-House Optical Finishing (Only If You Edge On-Site)

Lens edger
Blocker
Tracer
Groover and drill tools (for certain frame types)
Safety gear required by the equipment vendor

Clinic Technology And Security

Electronic health record and scheduling system
Workstations or tablets for exam rooms
Secure network equipment (router/firewall)
Encrypted backup system
Document scanner
Secure printing tools

Cleaning And Safety Essentials

Medical-grade surface disinfectants
Hand hygiene supplies
Instrument cleaning supplies
Disposable gloves (as appropriate for tasks)
Sharps container (only if sharps are used)

Step 6: Write A Business Plan That Fits Real Life

You don’t need a perfect business plan to open. You do need a plan that shows how you’ll get to opening day without guessing.

Even if you won’t seek funding, a plan keeps your steps in order and helps you spot gaps early.

Use how to write a business plan as a guide, then tailor it to optometry.

Practice model and service list
Target patient groups and local demand proof
Startup budget categories and timing
Staff roles for opening day versus later
Equipment ordering plan and setup schedule
Compliance checklist and provider enrollment timeline
Marketing plan for your first 60–90 days

Step 7: Choose A Location That Patients Can Actually Use

This is a location-based business. Convenience matters, because patients don’t want a complicated trip for routine eye care.

You’re looking for easy access, enough parking, and a space that can safely support clinical care.

Before you sign anything, confirm the use is allowed. Zoning rules vary, and medical office requirements can affect your buildout.

A good starting reference is business location considerations, then confirm local rules with your city or county.

Also plan for accessibility. Patient-facing medical offices must meet accessibility requirements during construction and alterations.

Entry and waiting areas that allow safe access
Hallways and door clearance that support mobility devices
Restroom access (if provided)
Clear wayfinding in the clinic

Step 8: Form The Business And Register For Taxes

Most small businesses start as sole proprietorships and later form a limited liability company as they grow. That can add liability protection and clearer structure.

But optometry is a licensed professional practice, and your state may require a specific business structure. So you verify the rules before filing.

Start with how to register a business, then confirm your state requirements through your Secretary of State and state optometry board.

Choose a business structure allowed for licensed optometry practice in your state
Register the business with your state (if required)
Apply for an Employer Identification Number with the Internal Revenue Service
Open business accounts at a financial institution
Register for state tax accounts if you will have employees or taxable retail sales (varies by state)

If you plan to hire staff right away, you’ll also need employer accounts for payroll taxes and unemployment insurance at the state level.

Step 9: Handle Compliance Before You See Your First Patient

This step is non-negotiable. You’re handling protected health information and clinical prescriptions, so you need the right systems in place before opening day.

Don’t wait until you’re “almost open.” Some steps take longer than you expect.

National Provider Identifier and payer setup

Apply for a National Provider Identifier if you will bill insurance or participate in standard health care transactions
Begin Medicare enrollment early if you plan to bill Medicare
Start credentialing and contract setup with commercial and vision plans if you will participate

HIPAA privacy and security

Choose systems that support privacy and security requirements for electronic patient data
Limit access to patient records by role
Secure your network and backup systems

Prescription release rules

Set up an eyewear prescription release process and required confirmations
Set up contact lens prescription release and verification response procedures
Train staff on how to document prescription release correctly

Workplace safety

Follow Occupational Safety and Health Administration rules that apply to your clinic and staff roles
Prepare cleaning and safety processes aligned with your equipment and clinical tasks

Step 10: Get The Right Insurance And Risk Coverage

You don’t buy insurance to “feel safe.” You buy it because one incident can wipe out months of progress.

Start with the basics, then add coverage based on your setup and contracts.

A solid overview is business insurance. Then confirm what your landlord, lenders, and state rules require.

General liability: protects against common third-party claims
Property and equipment coverage: important if you own high-value diagnostic tools
Professional liability: common for licensed care providers
Workers’ compensation: often required when you have employees (rules vary by state)

Step 11: Choose A Name And Build Your Online Presence

Your name needs to be clear, available, and usable across your website and business profiles. You’re not just naming a clinic—you’re naming something patients will search for and remember.

Start with selecting a business name, then check domain and social handle availability.

Next, build your basic presence so patients can find you.

Website with services, location, and contact options (see how to build a website)
Business cards for referrals and local networking (see business cards guidance)
Sign planning that follows local rules (see business sign considerations)
Basic brand identity assets (see corporate identity package)

Step 12: Set Pricing And Choose Suppliers

Pricing is more than picking a number. Your prices need to fit your costs, your area, and your service model.

If you plan to dispense eyewear, supplier relationships become a major part of your setup.

On the supplier side, you may need relationships with vendors like these.

Frame suppliers and distributors
Lens labs for prescription lenses
Contact lens vendors (and trial set support)
Equipment vendors for installation and training

Don’t rush this step. Good vendors support you when problems come up, and problems always come up.

Step 13: Decide When To Hire And Who You Need First

You can start lean, but you still need coverage for patient-facing tasks. If you’re trying to do everything, you’ll burn out fast.

Choose roles based on your service menu and whether you dispense eyewear.

For hiring guidance, use how and when to hire and plan staged hiring.

Front desk: scheduling, phones, patient check-in, insurance verification
Technician support: pre-test work and room prep (based on services)
Optical support: frame selection and adjustments (if dispensing)

If you’re not hiring immediately, plan how you’ll cover these tasks yourself and how long that can realistically last.

Step 14: Plan Pre-Launch Marketing And Your Opening

Even a great clinic needs visibility. Your goal is simple—help the right people discover you and book appointments.

Start marketing before you open so you don’t launch in silence.

Because this is a brick-and-mortar clinic, focus on local discovery first.

Local listings and consistent business details
Website contact flow and appointment requests
Community partnerships (schools, employers, nearby clinics)
Clear signage and easy directions

For practical ideas, see how to get customers through the door and build a simple launch plan.

If you want a structured opening push, use grand opening ideas and adapt it to a health care clinic setting.

Step 15: Build Your Pre-Opening Checklist

This is your final “are we actually ready?” step. It’s better to delay opening by a week than open unprepared and create a bad first impression.

Use a checklist and verify every item.

Legal and compliance: business registration complete, required local approvals confirmed, privacy and security processes ready
Provider setup: National Provider Identifier complete, payer enrollment steps started where needed
Equipment readiness: exam lane installed, calibrated, staff trained
Optical readiness (if dispensing): frame display ready, lens ordering flow tested
Payment systems: ability to accept payment, invoices and receipts ready
Patient paperwork: forms prepared, prescription release process documented
Staff readiness: basic training complete and roles clear
Marketing kickoff: website live, local listings updated, opening message ready

Funding is part of readiness too. If you need outside capital, review how to get a business loan so you understand what lenders look for.

And don’t skip the basics—business accounts at a financial institution, clean bookkeeping categories, and a plan for your first few months of expenses.

Varies By Jurisdiction

Optometry is regulated at the state level, and business rules vary by city and county. So you verify locally before you commit to a lease, a buildout, or equipment orders.

Use this checklist to confirm what applies to your exact location and setup.

State optometry board: license rules, scope of practice, any extra privileges, advertising rules
Secretary of State: business formation options and any professional entity requirements
State tax agency: employer registration, sales and use tax rules (if dispensing retail goods)
City or county licensing office: local business license requirements
Planning and zoning department: medical office use approval for your address
Building department: permits, inspections, and Certificate of Occupancy requirements
Fire marshal (when required): inspections related to occupancy and safety
Sign permitting office: exterior sign rules and permit steps

If you want to avoid common early headaches, also review avoid these mistakes when starting a small business and apply them to your clinic timeline.

A Day In The Life As An Optometry Practice Owner

Your days will be a mix of patient care and business tasks. If you’re the optometrist, you’ll spend most of the day in exams, but you’ll still have admin work before and after.

If you include an optical dispensary, you’ll also have retail decisions in the flow.

Review the schedule and prep for the first patients
Perform exams and refractions
Review testing and imaging results (when used)
Write prescriptions and coordinate follow-ups
Handle referrals and records requests
Review vendor orders and equipment issues
End the day with documentation and next-day prep

Red Flags To Watch For Before You Commit

Red flags can show up in the lease, the equipment deal, the compliance plan, or the numbers. Catch them early and you save yourself months of stress.

If something feels unclear, slow down and verify it.

Signing a lease before confirming zoning approval for medical office use
Buying major equipment without clear installation, training, and service support
Opening without a documented prescription release process
Assuming insurance credentialing will be fast without confirming timelines
Building a large optical inventory without proof of local demand
No plan for privacy and security controls for electronic patient records
Underestimating staffing needs for patient flow and optical support

101 Tips to Start and Grow an Optometry Practice

This section pulls together practical tips that cover the full journey, from your first planning steps to daily habits that keep the clinic strong.

Use what fits your goals and skip anything that doesn’t apply to your setup.

Bookmark this page so you can come back to it as your practice changes.

Pick one tip at a time, implement it, then move to the next when the timing is right.

What to Do Before Starting

1. Decide if you want to own a business and if an optometry practice fits your personality, patience, and risk tolerance.

2. Write down what you will offer on day one, then cut it down to what you can deliver confidently without rushing.

3. Choose your practice model early: exam-only, full-service with an optical dispensary, or a specialty-focused clinic.

4. Identify your “ideal patient mix” before you pick a location—families, contact lens users, older adults, or medically complex cases.

5. Confirm state licensing and scope rules before you invest in services that may require extra privileges or training.

6. Build a simple demand check by calling nearby clinics as a patient and asking about new-patient wait times.

7. Compare at least five competitors in your area and note their hours, services, reviews, and insurance acceptance patterns.

8. Make a startup equipment list before you shop for a space so you know what rooms you need and how much power and wiring may be required.

9. Pick a realistic launch pace—starting with fewer appointment slots can protect your quality while you refine your workflow.

10. Plan your exam lane layout on paper before buildout so you don’t waste money moving outlets, lights, or cabinetry later.

11. Decide if you will sell eyewear on-site, because an optical dispensary changes staffing, inventory, and your checkout process.

12. Ask every vendor about lead times, installation requirements, training, and service coverage before you place orders.

13. Estimate your monthly fixed costs first, then work backward to the patient volume you need to break even.

14. Price your services and products with enough margin to cover expenses and still pay the owner, not just to “match the market.”

15. Create a pre-launch timeline that includes credentialing, equipment delivery, buildout, and system testing.

16. Choose a business name you can legally use, and secure the matching domain before you print anything.

17. Set up a business bank account early so you can separate personal and business spending from day one.

18. Start a simple business plan that lists your model, location strategy, budget, staffing plan, and opening checklist.

What Successful Optometry Practice Owners Do

19. They protect the patient experience first, even when they’re busy, because trust is the real long-term advantage.

20. They standardize how patients move through the visit so every staff member knows what “done right” looks like.

21. They treat documentation as part of care, not as an afterthought at the end of a long day.

22. They keep a tight equipment maintenance schedule so small issues don’t turn into canceled clinic days.

23. They invest in training early so staff can handle more tasks without constant supervision.

24. They keep the optical area organized and easy to browse, because confusion kills retail conversion.

25. They track why patients choose them by asking a simple question at first visit: “How did you hear about us?”

26. They build relationships with reliable labs and suppliers so orders stay consistent during busy stretches.

27. They keep a short “what we do best” message that every staff member can say in the same words.

28. They leave buffer space in the schedule for urgent needs, adjustments, and patient questions.

29. They use a recall system for annual exams and contact lens renewals so revenue is not “start over every month.”

30. They set clear expectations with patients about turnaround times for eyewear and contacts before checkout.

31. They review no-shows and late cancels weekly and adjust reminder timing and policies based on patterns.

32. They keep compliance organized so audits, payer requests, and record needs don’t become a crisis.

Running the Business (Operations, Staffing, SOPs)

33. Start with the smallest staffing plan that still protects patient flow—one strong front desk hire can change everything.

34. Decide who handles phones, scheduling, and insurance checks before opening day so patients get consistent answers.

35. Write short step-by-step procedures for the most repeated tasks: check-in, pre-test, room turnover, and checkout.

36. Make a daily opening checklist that includes powering equipment, cleaning surfaces, and confirming the schedule.

37. Make a daily closing checklist so charts are complete, rooms are reset, and orders are confirmed.

38. Use appointment reminders by text or email, and test the timing until your no-show rate drops.

39. Keep a simple “same-day issue” system so staff knows when to offer urgent visits versus the next opening.

40. Create a standard way to present lens options so patients understand upgrades without feeling pressured.

41. Train staff to repeat back key details at checkout, including follow-up timing and expected delivery dates.

42. Build a clean process for prescription release so it happens automatically and is documented correctly every time.

43. Keep contact lens verification requests organized so responses are handled on time and don’t pile up.

44. Use a secure electronic health record setup and restrict staff access by role, not by convenience.

45. Store patient information securely and confirm your systems support privacy and security requirements for health data.

46. Create a plan for handling requests for records and referrals so patients aren’t waiting days for paperwork.

47. Set up payment processing before you open, then run test transactions so checkout is smooth.

48. If you dispense eyewear, track frame inventory by category so you reorder based on what sells, not guesswork.

49. Keep a designated space for repairs and adjustments so small fixes don’t disrupt the entire clinic.

50. If you edge lenses in-house, build safety and dust control into the layout so the area stays clean and compliant.

51. Create a simple staffing ramp plan: hire lean at first, then add optical and technician coverage as volume grows.

52. Cross-train staff so one call-out doesn’t collapse the schedule.

53. Set service standards for phone answering, greeting, and follow-up calls so patients feel cared for every time.

54. Run a weekly “mini-audit” of charts and orders to catch errors before they become refunds or remakes.

What to Know About the Industry (Rules, Seasons, Supply, Risks)

55. Optometry is regulated at the state level, so your scope of practice and business structure rules can change depending on where you open.

56. If you plan to bill Medicare, start enrollment early because approval timing can affect when you can submit claims.

57. Get a National Provider Identifier before you need it, so payer setup and electronic transactions don’t stall your opening.

58. Prescribers must follow federal prescription release and confirmation rules for eyeglass prescriptions, even if the practice does not sell eyewear.

59. Contact lens prescriptions also have federal release and verification requirements, so build that workflow before you open.

60. If your clinic handles situations with occupational exposure risk, follow workplace safety requirements for staff training and controls.

61. If you build or renovate a patient-facing space, confirm accessibility rules are met during construction and alterations.

62. Insurance credentialing can take longer than expected, so plan cash flow as if approvals will be slow.

63. Optical suppliers and labs can have seasonal delays, so order critical items early and keep backup options.

64. Equipment downtime is a major risk, so ask vendors about service response time and loaner options before buying.

65. Vision plans and medical insurance rules are different, so train staff to explain benefits without guessing.

66. If you plan to prescribe controlled substances, verify federal and state registration rules before you offer that service.

67. State and local rules may affect signage, zoning, and occupancy approval, so confirm requirements before buildout begins.

Marketing (Local, Digital, Offers, Community)

68. Treat your online presence like a storefront—patients decide if they trust you before they ever call.

69. Build a website that clearly shows services, hours, location, and how to book an appointment in under 10 seconds.

70. Use plain-language service pages that explain what happens during an exam and what patients should bring.

71. Make your phone number easy to find on every page and make sure calls are answered consistently.

72. Set up your local business listing profiles early so you can collect reviews from your first week.

73. Ask happy patients for reviews right after a good visit, not weeks later when they forget.

74. Focus on local search phrases patients actually use, like “eye exam near me” and “contact lens fitting.”

75. Take real photos of your clinic and team because patients trust what feels familiar.

76. Create a simple new-patient offer that lowers friction, such as easy scheduling or extended first-visit time, not discount games.

77. Partner with nearby businesses like dentists, pediatric offices, and gyms for referral relationships that benefit both sides.

78. Build relationships with schools and employers if your area has families and working adults who need routine care.

79. Use short educational posts on social media that answer common questions patients are already searching for.

80. Promote your specialty strengths if you have them, but never claim services you can’t consistently deliver.

81. Run a soft opening with limited slots and invite early patients to give honest feedback on the experience.

82. Plan a grand opening week with simple community outreach, clear signage, and friendly staff coverage for first impressions.

Dealing with Customers (Trust, Education, Retention)

83. Explain findings in everyday language and confirm understanding before the patient leaves the exam room.

84. Use visuals when possible—showing a patient what you’re seeing can increase trust and follow-through.

85. Set expectations for adaptation time with new prescriptions so patients don’t feel blindsided.

86. Teach contact lens wear and care clearly, and give patients a way to ask questions after the visit.

87. If a patient is anxious, slow down and narrate what you’re doing so the exam feels safe and predictable.

88. Offer clear next steps at the end of every visit, even if the next step is simply “come back in a year.”

89. When a patient needs a referral, explain why and send the referral quickly so care does not stall.

90. Follow up on first-time contact lens patients because early discomfort is a common reason people quit.

91. Create a recall system that reminds patients before they lapse, not after they disappear.

92. Train staff to handle complaints with empathy first, then solutions, because tone matters as much as the fix.

Adapting to Change (Seasonality, Shocks, Competition, Tech)

93. Expect schedule swings around back-to-school and holiday seasons, and staff accordingly.

94. Keep a cash buffer so you can survive slow weeks without cutting corners on care.

95. Watch competitor shifts like extended hours, new providers, or new locations so you can respond early.

96. Adopt new tools only when they improve speed or accuracy without lowering patient understanding.

97. Review payer policies and documentation rules regularly because billing changes can affect cash flow fast.

98. Update your service list as your patient base grows, but expand slowly so quality stays stable.

What Not to Do

99. Don’t sign a lease before confirming zoning approval, occupancy requirements, and buildout rules for a medical office in your local area.

100. Don’t buy major equipment without knowing service response times, training requirements, and what happens when something breaks.

101. Don’t open without a documented prescription release process and staff training, because compliance mistakes can become expensive quickly.

If you treat these tips like a checklist instead of a reading exercise, you’ll move faster and make fewer expensive choices.

Start simple, build strong habits, and improve one part of the practice at a time—patients notice consistency more than perfection.

FAQs

Question: What licenses do I need to open an optometry practice?

Answer: You need an active optometry license in the state where you will practice.

Some states also require extra approvals for certain procedures, so confirm your state’s rules before you offer those services.

Question: Where do I check my state’s optometry scope-of-practice rules?

Answer: Start with your state optometry board and read the current laws and rules they publish.

A reliable shortcut is the Association of Regulatory Boards of Optometry directory, which helps you find your state board.

Question: Do I need an Employer Identification Number before I open?

Answer: Many optometry practices get an Employer Identification Number early because it is widely used for banking, taxes, and payroll.

You can apply for it directly through the Internal Revenue Service at no cost.

Question: Do I need a National Provider Identifier to run an optometry practice?

Answer: If you plan to bill health plans electronically, you will likely need a National Provider Identifier as part of standard health care transactions.

You can apply online through the National Plan and Provider Enumeration System.

Question: How does Medicare enrollment work if I want to bill Medicare?

Answer: If you plan to bill Medicare, you must complete the provider enrollment process and keep your enrollment information current.

Many actions are handled through the Medicare Provider Enrollment, Chain, and Ownership System.

Question: What business licenses or permits apply to an optometry clinic space?

Answer: Most locations require standard business registration steps, and a clinic space may also need local approvals tied to zoning and occupancy.

Check with your city or county business licensing office and your local building department before you sign a lease.

Question: What is the first compliance step I should handle for patient privacy?

Answer: Treat patient information as protected health information from day one and choose systems that support secure access.

If you send standard health transactions electronically, you may fall under Health Insurance Portability and Accountability Act rules as a covered entity.

Question: Do I need to meet accessibility rules when I open a new clinic?

Answer: Medical offices that serve the public generally need to meet accessibility requirements under the Americans with Disabilities Act.

If you are building out or remodeling, review the ADA Accessibility Standards before construction starts.

Question: Do I need an OSHA bloodborne pathogens plan in an optometry practice?

Answer: If staff can reasonably be exposed to blood or other potentially infectious materials, the Bloodborne Pathogens standard can apply.

That can include having an exposure control plan and training for affected roles.

Question: What insurance should I have in place before opening day?

Answer: Most owners carry general liability and professional liability coverage before seeing patients.

Your lease, lender, or payer contracts may also require property coverage for your space and equipment.

Question: What equipment is essential to open with one exam lane?

Answer: Most setups include a refractor or phoropter, a vision chart system, a slit lamp, and a tonometer.

You also need basic diagnostic tools, a patient chair, and a workstation that supports your electronic health record.

Question: Should I open exam-only or include an optical dispensary from the start?

Answer: Exam-only can lower complexity at launch because it avoids frame inventory and lab order systems.

An optical dispensary can add revenue, but it also adds staffing needs, vendor relationships, and more room buildout.

Question: How do I choose an electronic health record system for a new optometry practice?

Answer: Start by listing your must-haves, like charting speed, e-prescribing support, imaging links, and insurance tools.

Then confirm pricing, training, support hours, and how the system handles data security and access roles.

Question: How do I set pricing if I accept vision plans and medical insurance?

Answer: Build pricing around your costs and time, then layer in contracted rates from the plans you accept.

Make sure the mix of exam fees, product sales, and reimbursements can cover overhead and pay the owner.

Question: How long does insurance and vision plan credentialing take?

Answer: Credentialing timelines vary and can take longer than expected, so start early.

Plan cash flow as if approvals will not be instant, especially if insurance billing is a key part of your plan.

Question: Do I have to give patients their eyeglass prescription right after the exam?

Answer: Under the Federal Trade Commission’s Eyeglass Rule, prescribers must provide the eyeglass prescription after the refractive exam.

You also must keep required confirmation records for the timeframe listed in the rule.

Question: What is the biggest workflow mistake new optometry practice owners make?

Answer: They overbook early and end up rushing exams, which harms trust and increases remakes and complaints.

Start with fewer daily slots, tighten the process, then scale your schedule with confidence.

Question: What should I track weekly to know if my practice is healthy?

Answer: Track scheduled visits, completed visits, no-shows, average revenue per visit, and outstanding claims.

Also track optical remake rates and lab turnaround times if you dispense eyewear.

Question: How do I reduce no-shows and late cancellations without upsetting patients?

Answer: Use clear reminders, confirm visits in advance, and set a written policy for repeated missed appointments.

Offer easy rescheduling options so patients don’t disappear when life gets busy.

Question: How do I handle contact lens verification requests correctly?

Answer: The Contact Lens Rule includes verification requirements, including an “eight business hours” window tied to passive verification.

Set a daily process so requests are reviewed, corrected when needed, and documented consistently.

Sources:

Federal Trade Commission: Complying Eyeglass Rule, Contact Lens Rule Guide
Internal Revenue Service: Get employer ID number
U.S. Department of Health & Human Services: HIPAA Privacy Rule, Covered entities basics
Occupational Safety and Health Administration: Bloodborne pathogens 1910.1030
U.S. Access Board: ADA accessibility standards
Association of Regulatory Boards of Optometry: Optometry boards directory
American Optometric Association: What is doctor optometry
U.S. Bureau of Labor Statistics: Optometrists outlook
Electronic Code of Federal Regulations: 16 CFR Part 315
ADA.gov: Public accommodations Title III

Starting an Optometry Practice: Licensing, Space, Setup