Optometrists perform an estimated 88 million refractive eye exams annually (85% of the total 104 million performed by all eyecare professionals) and prescribe at least 90% of vision correction devices. Comprehensive eye exams and corrective devices account for at least 80% of the optometrist’s revenue. Of the 97 million office visits in 2012, approximately 18 million were for medical eyecare services, accounting for approximately 17% of revenue. It is estimated that 80-85% of optometrists are involved with medical eyecare, but it is a major source of income in less than 25% of these offices. The typical patient is examined once every 25 months. AOA member surveys show that the average number of comprehensive exams optometrists perform per hour is around 1.1 per hour.
Out of the 82.5 million pairs of glasses sold annually, corporate providers provided 54%, independent optometrists provided 32%, ophthalmologists provided 10%, and independent opticians provided 4%. Since independent optometrists perform 44% of refractive exams, they have a capture rate of approximately 73% or about 9.8 million pairs of glasses.
For contact lenses, optometrists provide about 90% of all contact lens prescriptions. It’s estimated that 16.1% of US adults wear contacts, a steady increase since the ‘70s, and account for 27% of the refractive exams performed by optometrists. Independent optometrists supply about 80% of their contact lens prescriptions.
Take home message: 1) Improve recall processes; 2) Upgrade eyewear purchase experience; 3) Broaden your scope of practice; 4) Increase hourly production; and 5) Differentiate the practice value proposition.
In 2012, there were about 40,000 optometrists in practice as compared to about 18,000 ophthalmologists. At the end of 2012, optometrists accounted for 69% of eyecare professionals in practice, by 2020 they will account for around 72%. The number of practicing optometrists has had steady growth of 1.8%. It is estimated that practicing optometrist growth will increase to approximately 2% annually through 2020 and reach 46,300. It’s also estimated that about 1,550 optometrists will graduate and enter practice annually while about 750 optometrists will retire. There will also be an expected gender shift. Over the next ten years, 65% of new optometrists will be females and 90% of retiring optometrists will be males. Currently, the male/female ratio is 61%/39%; in 2022, it is likely to be a 48%/52% ratio.
Approximately 57% of optometrists are in private practice, 24% have an optical chain affiliation; 8% are in an ophthalmology practice; and 5% are in other medical practices.
The number of practicing optometrists will grow faster than routine vision care demand (a projected 11% vs. 9% through 2020) but more slowly than the demand for medical eyecare (a projected increase in cataracts [2.3%], diabetic retinopathy, POAG, ARMD [1.8% each] through 2020). Presently, optometrists perform approximately 45% of Medicare-reimbursed comprehensive eye exams. The Census Bureau projects a 28% increase in individuals over 55 years of age between 2010 and 2020, while the total populations will grow by about 10%.
… Optometry’s largest opportunity is to increase eyecare demand among existing patients, expanding care to the elderly and other populations at risk for treatable diseases.
A historical review
Optometry’s scope of practice continues to broaden…
1897: First bill introduced to license optometrists in New York
1901: First law licensing optometrists enacted in Minnesota
1921: Last state law licensing optometrists enacted in Texas (D.C. enacted in 1924)
1923: Pennsylvania College of Optometry awarded first Doctor of Optometry degree
1971: First state law allowing the use of diagnostic drugs enacted in Rhode Island
1976: First state law allowing Rx of legend drugs enacted in W. Virginia (and on a veto override)
1976: First state authorizing Tx of glaucoma enacted in West Virginia
1977: First state authorizing Rx of oral drugs enacted in North Carolina
1997: Last state authorizing Rx of legend drugs enacted in Massachusetts (D.C. in 1998)
1998: Authority to use therapeutic lasers enacted in Oklahoma
2011: Kentucky legislature becomes the first state to repeal a statutory prohibition on the performance of surgery by optometrists and the second state to authorize the use of therapeutic lasers
2013: Pediatric exams (and materials) decreed as an essential yearly health benefit, as the result of AOA legislative activity
2014: Under the ACA, increased insurance enrollment will expand accessibility to optometric eyecare
…As you can see, we are a legislated profession and we can thank organized optometry for progressing optometry forward. Be involved as a volunteer and as a donator to PAC funds to assure the continued evolution of your profession…as newly elected AOA trustee Dr. Greg Caldwell says, ”for the love of optometry.”
Robert L. Owens, O.D., F.A.A.O.
Pennsylvania Optometric Association
Pennsylvania Optometric Association