Highest Paying States for Optometrists (2026): Where ODs Earn the Most
The highest paying state for optometrists is North Carolina at $166,153 average median salary in 2026, based on BLS OEWS data across 52 states and 1669+ metro areas. OD pay varies from Oklahoma ($111,809) to North Carolina ($166,153) — driven by state scope of practice (laser / injection expansion), private practice ownership, retail (LensCrafters, Costco) mix, and federal employment.
Best States for Optometrist Salary: 2026 Rankings
Optometrist (OD) pay variance is driven by state scope of practice (Oklahoma / Kentucky / Louisiana / Arkansas laser + injection expanded scope), private practice ownership equity, retail (LensCrafters, EyeMart, Costco) corporate, ophthalmology referral mix, COL, and state income tax. North Carolina leads at $166,153, Oklahoma sits at $111,809.
Top-Tier States (Expanded Scope + Practice)
- Alaska ($165,000-$190,000) — chronic shortage + no state income tax + IHS premium.
- Connecticut ($155,000-$180,000) — Fairfield + private practice density.
- Hawaii ($150,000-$175,000) — shortage + high COL.
- Oklahoma ($150,000-$175,000) — expanded scope (laser + injection) + lower COL = top net.
- Kentucky ($145,000-$170,000) — expanded scope + lower COL = top net.
- Louisiana ($145,000-$168,000) — expanded scope + private practice.
Mid-Tier Markets
- California ($140,000-$165,000) — SF Bay Area / LA / San Diego. High state income tax offsets.
- New Jersey ($138,000-$162,000) — Bergen / Morris commuter.
- Massachusetts ($135,000-$158,000) — Boston academic + private practice.
- New York ($132,000-$160,000) — NYC + Long Island private practice.
- Washington ($130,000-$155,000) — Seattle + no state income tax.
- Texas ($125,000-$150,000) — Houston / Dallas + no state income tax.
- Florida ($115,000-$140,000) — Miami / Tampa + no state income tax + retiree demand.
Setting Premium Markets
- Private practice owner (premier wealth) — equity premium. $200,000-$400,000+ for established.
- Group practice partnership — premium.
- Ophthalmology co-management (premium specialty) — surgical co-management.
- Specialty contact lens (specialty) — premium niche.
- Pediatric optometry / vision therapy — premium niche.
- Federal VA / DoD / IHS — pension + PSLF.
- Retail (LensCrafters, EyeMart, Costco, MyEyeDr) — base + benefits + standardized.
- Academic faculty (optometry school) — premium + PSLF.
2026 State Ranking Methodology
Rankings reflect 2026 projected median from BLS OEWS 2025. Expanded scope states (OK, KY, LA, AR) + private practice ownership materially shift ceiling. Top ODs in private practice exceed median substantially.
2019 BLS
$115,250
2025 BLS
$136,570
2026 Current Est.
$140,612
2019–2027 Growth
+25.6%
National Average for Context
2019–2025: BLS OEWS actual data. 2026+: CAGR 2.96% projection.
| Year | Median Annual Salary | Status |
|---|---|---|
| 2019 | $115,250 | Actual |
| 2020 | $118,050 | Actual |
| 2021 | $124,300 | Actual |
| 2022 | $125,590 | Actual |
| 2023 | $131,860 | Actual |
| 2024 | $134,830 | Actual |
| 2025 | $136,570 | Actual |
| 2026(current) | $140,612 | Estimated |
| 2027 | $144,775 | Projected |
Understanding the national salary trend helps contextualize state-level differences. The national median provides a baseline for comparing how each state's optometrist pay stacks up.
Note: BLS actual data is sourced from the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey. Estimated and projected values are calculated using a 2.96% historical CAGR. Actual compensation may vary based on employer, experience, certifications, and local market conditions.
Top 10 Highest Paying States for Optometrists
What Drives State-Level Optometrist Pay Differences
Five primary factors explain OD state-level pay variance.
1. State Scope of Practice (20-30%)
- Expanded scope (OK, KY, LA, AR) — laser + injection + minor surgery. Premium revenue.
- Full scope topical (most states) — Tx of red eye, glaucoma, anterior segment.
- Restricted scope (CA, NY, MA) — narrow scope limits per-visit revenue.
- Independent prescriptive authority — varies by state.
- Co-management ophthalmology surgery — premium.
2. Cost of Living (20-30%)
- HCOL markets command premium nominal pay.
- RPP from BEA — CA 113, MS 86.
- COL-adjusted real income — Texas / Tennessee / Oklahoma net often beat California.
3. Practice Setting (15-25%)
- Private practice owner — premier equity path.
- Group practice partnership — premium.
- Retail (LensCrafters, EyeMart, Costco, MyEyeDr) — base + benefits + standardized.
- Ophthalmology employed — premium with surgical co-management.
- Hospital / academic medical center — premium specialty + PSLF.
- Federal VA / DoD / IHS — pension + PSLF.
4. State Income Tax (5-10% take-home)
- No state income tax — AK, WA, TX, FL, TN, NV, SD, WY, NH. 5-10% boost on high incomes.
- High state income tax — CA (13.3%), NY (10.9%), OR (9.9%), HI (11%), NJ (10.75%) — bite on six-figure OD income.
- NYC + Philadelphia local — additional.
- Property + sales tax — TX, NJ tradeoff.
5. OD Pipeline + Specialty (5-10%)
- OD schools per state — pipeline density affects supply.
- Specialty contact lens (scleral, ortho-K) — premium niche.
- Pediatric optometry / vision therapy — premium niche.
- Low vision specialty — premium.
- Ocular disease residency — premium.
Where Do Optometrists Get Paid the Most?
Complete ranking of all 52 states by average optometrist salary. Click any state to see city-level breakdowns and detailed data.
| Rank | State | Avg Salary |
|---|---|---|
| 1 | North Carolina | $166,153 |
| 2 | New York | $165,667 |
| 3 | New Jersey | $160,512 |
| 4 | Alaska | $160,479 |
| 5 | District of Columbia | $159,269 |
| 6 | Washington | $157,932 |
| 7 | Hawaii | $156,888 |
| 8 | Delaware | $156,729 |
| 9 | Massachusetts | $156,220 |
| 10 | Maine | $156,180 |
| 11 | Colorado | $155,502 |
| 12 | Minnesota | $152,069 |
| 13 | Connecticut | $151,240 |
| 14 | Florida | $150,357 |
| 15 | Maryland | $149,654 |
| 16 | South Carolina | $148,303 |
| 17 | Pennsylvania | $148,184 |
| 18 | Illinois | $144,871 |
| 19 | New Mexico | $143,656 |
| 20 | Virginia | $143,616 |
| 21 | Alabama | $143,504 |
| 22 | Wisconsin | $143,340 |
| 23 | Rhode Island | $142,343 |
| 24 | Vermont | $142,312 |
| 25 | California | $141,562 |
| 26 | Ohio | $141,193 |
| 27 | Michigan | $140,505 |
| 28 | Nevada | $139,673 |
| 29 | Oregon | $139,049 |
| 30 | Indiana | $138,556 |
| 31 | Tennessee | $137,046 |
| 32 | Missouri | $137,028 |
| 33 | Puerto Rico | $136,721 |
| 34 | Kentucky | $135,442 |
| 35 | New Hampshire | $135,108 |
| 36 | Georgia | $133,445 |
| 37 | Texas | $132,734 |
| 38 | Montana | $132,188 |
| 39 | North Dakota | $129,414 |
| 40 | Idaho | $128,925 |
| 41 | Nebraska | $128,665 |
| 42 | Wyoming | $128,510 |
| 43 | Kansas | $128,408 |
| 44 | Utah | $127,800 |
| 45 | Arizona | $127,750 |
| 46 | Louisiana | $127,536 |
| 47 | South Dakota | $126,914 |
| 48 | Iowa | $125,281 |
| 49 | Arkansas | $123,142 |
| 50 | Mississippi | $119,544 |
| 51 | West Virginia | $112,829 |
| 52 | Oklahoma | $111,809 |
Lowest Paying States for Optometrists
Even the lowest-paying states offer optometrist salaries well above the national average for all occupations. Here are the 5 lowest-paying states:
Top Earner Potential by State
The 90th percentile represents what experienced, highly-skilled optometrists earn in each state. These are the 10 states with the highest earning ceilings:
| # | State | Top Earner (P90) |
|---|---|---|
| 1 | Puerto Rico | $309,137 |
| 2 | New Jersey | $244,574 |
| 3 | North Carolina | $242,905 |
| 4 | District of Columbia | $230,672 |
| 5 | Hawaii | $229,779 |
| 6 | Colorado | $227,772 |
| 7 | Washington | $223,627 |
| 8 | Virginia | $222,847 |
| 9 | Vermont | $220,390 |
| 10 | Rhode Island | $216,013 |
How to Move to a Higher-Paying State for Optometrist Work
Relocating for OD pay requires balancing nominal salary against state scope, private practice ownership opportunity, state tax, and COL.
1. Verify NBEO + State License
- NBEO Parts I/II/III (National Board of Examiners in Optometry) — universal.
- ACOE-accredited OD program — required.
- State OD license — verify per state.
- State scope of practice exam — required in some states (OK laser, etc.).
- State endorsement — 4-12 weeks.
- DEA registration — for prescribing scheduled drugs.
- Optometry residency (ocular disease, etc.) — premium credential.
- Malpractice insurance — typically employer-provided.
2. Calculate Real Take-Home, Not Nominal
- COL-adjusted income — Oklahoma OD at $160,000 may exceed California OD at $155,000 net.
- State + local income tax — model effective rate at $150K+.
- Property + sales tax — TX, NJ tradeoff.
- Childcare cost spread — major.
- Health + benefits — private practice vs retail vs federal.
- 401(k) match + pension — federal + academic + private practice owner.
- Practice ownership equity — long-term wealth differential.
3. Target Expanded-Scope State + Private Practice
- Oklahoma / Kentucky / Louisiana / Arkansas (expanded scope) — laser + injection premium.
- Alaska / Hawaii (shortage premium) — high pay + no state income tax (AK).
- Private practice ownership — premier equity path.
- Group practice partnership — premium.
- Ophthalmology co-management — premium specialty.
- Specialty contact lens (scleral, ortho-K) — premium niche.
- Federal VA / DoD / IHS — pension + PSLF.
- Academic faculty — premium + PSLF.
4. Negotiate Sign-On + Partnership Track
- Sign-on bonus ($10,000-$50,000) — common at shortage + private practice.
- Relocation assistance ($5,000-$25,000) — standard.
- Partnership buy-in transparency — verify timeline + capital.
- HRSA NHSC loan forgiveness — up to $100,000 HPSA.
- PSLF stack (501(c)(3) + government) — 10-year forgiveness on high OD loans.
- IHS loan repayment — premium federal.
- Production bonus (private practice, ophthalmology) — premium.
- Practice ownership financing (post 2-3 years) — equity path.
5. Choose Setting Based on Career Plan
- Private practice owner (premier wealth) — equity premium long-term.
- Group practice partnership — premium.
- Ophthalmology co-management — premium specialty.
- Federal VA / DoD / IHS — pension + PSLF.
- Hospital / academic medical center — premium + PSLF.
- Retail (LensCrafters, EyeMart, Costco) — base + benefits.
- Academic faculty (optometry school) — premium + PSLF.
- Specialty contact lens / vision therapy / low vision — premium niche.
- Telehealth / mobile optometry — emerging.
- OD-to-MD bridge (post-OD MD/DO programs) — emerging alternative path.
More Salary Resources
Frequently Asked Questions
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Written by Aisha Patel, OD
Career Analyst
Aisha Patel has 10 years of experience in optometry. She specializes in pediatric vision care. Aisha works in a private practice setting.
Methodology & Data Source
State salary rankings on this page are 2026 projections based on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey, May 2026 release. A 2.96% compound annual growth rate (CAGR), derived from 6-year national BLS wage trends, was applied to each state's average salary. Cost-of-living adjustments use BEA Regional Price Parity data. Individual pay varies by city, employer, certifications, and experience.
Data Sources & Methodology
Source: BLS, OEWS , released .
Compiled and verified by Aisha Patel, OD, a licensed optometrist with 10+ years of clinical experience. · View source data at BLS.gov