Optometrist Salary by State (2026): OD Pay Compared Across All 50 States

Optometrist salary by state varies meaningfully across the U.S. — the spread reflects state-level optometric scope-of-practice laws (which directly affect billable services), the regional mix of corporate retail optometry vs private practice ownership, the local concentration of VA medical centers and federally qualified health centers, and ACOE-accredited optometry school graduate supply. The national median for Optometrists sits at $140,612, but state-by-state pay across the 52 states tracked here ranges widely — from $111,809 in Oklahoma to $166,153 in North Carolina.

This page compares the average optometrist salary by state across 1669+ metropolitan and non-metropolitan areas — drawing on the Bureau of Labor Statistics Occupational Employment and Wage Statistics (OEWS) survey for SOC 29-1041. If you're a working OD evaluating relocation, a fourth-year optometry student selecting residency or first practice, or a corporate optometry recruiter benchmarking pay across states, the state-level comparison below is the central reference point.

How Optometrist Salary by State Is Measured

The BLS reports state-level optometrist salary through three numbers:

• Annual median (50th percentile) — used to rank state-level pay in the table below.
• Annual mean (average) — typically runs 5–10% above median; states with strong private-practice ownership concentration show wider mean-median spreads because owner-ODs include practice profit and equity build.
• Percentile distribution (P10 / P25 / P75 / P90) — P10 reflects entry-level corporate retail ODs at LensCrafters, Pearle Vision, Visionworks, Walmart Vision, Costco Vision; P90 reflects established private-practice owners, fellowship-trained subspecialists (residency in ocular disease, pediatric optometry, low vision, primary care, cornea/contact lens), VA medical center senior ODs, and multi-location group practice owners.

The state-comparison table below applies BEA Regional Price Parity (RPP) adjustment so both nominal pay and real purchasing power are visible.

1. State Optometric Scope of Practice

The single largest non-cost-of-living driver of state-level OD pay is state optometric scope of practice — broader scope creates more billable services and higher per-encounter revenue:

• Therapeutic privileges and oral medication prescribing — all states now permit therapeutic privileges (TPA) and oral medication prescribing, but specific drug schedules vary by state.
• Optometric laser procedures — Oklahoma was first to authorize OD laser procedures (YAG capsulotomy, SLT for glaucoma, laser peripheral iridotomy). Other states with optometric laser authority: Kentucky, Louisiana, Alaska, Arkansas, Mississippi, Virginia, Wyoming, Colorado, South Dakota, Indiana. Laser-scope states support upper-percentile OD pay through expanded surgical-procedure revenue.
• Injection authority — periocular/orbital injection authority varies by state. Laser-scope states typically also grant broader injection authority.
• Lid procedure authority — minor eyelid procedures (cyst removal, chalazion excision) authorized in some scope-expansion states.
• Scope-restricted states — California, New York, Massachusetts, Texas, Hawaii historically have narrower optometric surgical scope than the laser-scope states. These states still have strong OD demand but rely more on medical optometry and contact lens revenue.

2. State Corporate Retail vs Private Practice Mix

The mix of corporate retail employment and private practice ownership drives state-level OD pay distribution:

• Corporate retail employers — LensCrafters (Luxottica/EssilorLuxottica), Pearle Vision, Visionworks, Walmart Vision Center, Costco Vision, Target Optical, MyEyeDr, America's Best (National Vision), Eyemart Express compete for OD talent. Corporate retail pay anchors entry-level OD salary across states.
• Private-practice density states — Texas, Florida, California, Pennsylvania, Ohio, North Carolina, New York have strong private-practice density. Owner-ODs in mature private practices reliably top state-level pay distributions.
• Private-equity backed group consolidation — MyEyeDr (Goldman Sachs / Altas Partners), Vision Innovation Partners, Acuity Eyecare Group, EyeCare Partners (Partners Group), Spectrum Vision Partners actively acquire private practices, especially in Texas, Florida, North Carolina, Pennsylvania, Ohio, Arizona, Tennessee. PE consolidation shifts the OD employment mix but stabilizes employed-OD pay in target states.
• Walmart class-action settlement (state) — recent state-level OD employment changes at Walmart Vision affect employed-OD pay floors in affected states.

3. State Cost of Living and Federal Employment

State cost of living and federal facility concentration drive nominal state-level pay:

• State cost of living — Alaska, North Dakota, South Dakota, Connecticut, New York, Massachusetts, California lead nominal OD pay rankings.
• State income tax variation — ODs in Texas, Florida, Tennessee, Nevada, Washington, Wyoming, South Dakota, Alaska, and New Hampshire keep more of every dollar.
• State VA medical center concentration — Texas (multiple VA facilities), California (multiple VA), Florida (multiple VA), Virginia (VA central administration + facilities), Maryland (VA HQ), New York, Pennsylvania have strong VA OD employment with federal pension + PSLF.
• State Indian Health Service (IHS) presence — Arizona, New Mexico, Oklahoma, South Dakota, Montana, Alaska have IHS facilities employing ODs with PSLF and loan repayment.
• State military treatment facility concentration — Texas, Virginia, Georgia, North Carolina, Florida, Washington, California have major military treatment facilities employing civilian and military ODs.

4. State Optometric Residency and ACOE Program Distribution

Residency and ACOE-accredited program distribution shape upper-percentile state OD pay:

• ACOE-accredited schools of optometry — California (Berkeley, Western University, Marshall B. Ketchum, Southern California College of Optometry), Illinois (ICO), Texas (UHCO Houston, Rosenberg), Pennsylvania (Salus, Pennsylvania College), Ohio (OSU), New York (SUNY), Indiana (IU), Massachusetts (NECO), Missouri (UMSL), Tennessee (Southern), Alabama (UAB), Oklahoma (NSU), Puerto Rico, Florida (NOVA), Arizona (Midwestern, Arizona College of Optometry), and others. School-density states have larger OD pipelines.
• Optometric residencies (ACOE-accredited) — VA medical center residencies, hospital-based residencies, and university-based residencies in ocular disease, primary care, pediatric optometry, vision therapy/rehabilitation, low vision, cornea and contact lens. Residency-trained ODs earn meaningful premiums.
• State Diplomate ABO concentration — American Board of Optometry diplomate status and AAO Fellowship (FAAO) cluster at high-residency-density states.

How to Compare Optometrist Salary by State Effectively

When comparing the average optometrist salary by state, work through this checklist:

• Verify state optometric scope — laser-scope and injection-scope states (OK, KY, LA, AK, AR, MS, VA, WY, CO, SD, IN) support broader billable services and upper-percentile pay.
• Compare nominal and real (cost-adjusted) pay together — a state with the highest nominal median can have lower real purchasing power if its cost of living is higher.
• Check state income tax — ODs in Texas, Florida, Tennessee, Nevada, Washington, Wyoming, South Dakota, Alaska, and New Hampshire keep more of every dollar. State income tax savings can reach $10,000–$25,000 annually for senior ODs.
• Compare percentile distribution, not just median — states with strong private-practice ownership concentration show wide P75–P90 spreads.
• Factor in employer mix — corporate retail anchors entry-level pay; private-practice and PE-backed group employment dominate mid-career; VA and federal facilities offer stable upper-mid-range pay with pension and PSLF.
• Consider residency path — residency-trained subspecialists earn 10–25% above non-residency-trained peers at the same career stage.
• Plan for state licensure portability — no national optometric licensure compact yet; multi-state practice requires state-by-state licensure.

2026 State-Level OD Salary Outlook

OD pay has grown at a compound annual rate of 2.96% nationally over the past five years — driven by ongoing scope expansion in laser and injection states, private-equity consolidation of private practices (which stabilizes employed-OD pay at acquired groups), growing chronic-disease management demand (diabetes screening, glaucoma management, AMD management), and steady aging-population growth. States with active scope-expansion legislation, states with rapid PE-backed group consolidation (Texas, Florida, North Carolina, Pennsylvania, Ohio, Arizona, Tennessee), and federal-facility-heavy states (Texas, California, Virginia, Maryland) are seeing the fastest state-level OD pay growth through 2026. The BLS projects Optometrists employment growth at 8% through 2033, keeping steady upward pressure on state-level wages.

Browse the state-by-state comparison table below to see the $140,612-baseline state ranking, top 10 and bottom 10 states by projected median, regional groupings (Northeast / Midwest / South / West), and direct links to per-state pages for deeper city-level breakdown.