An optometrist is a state-licensed doctor of optometry who examines eyes, diagnoses refractive errors and eye diseases such as glaucoma, and prescribes glasses, contact lenses and medication.
How far the job goes past that — which drugs, which procedures — is set by each state's law.
This page walks the work as the optometrist does it: the exam, the conditions managed, the tasks shared with staff, and the limits.
What does an optometrist do?
The U.S. Bureau of Labor Statistics (BLS) lists the profession's typical duties, and the list is the job in miniature:
- Examining eyes and performing vision tests.
- Diagnosing refractive errors and eye diseases such as glaucoma.
- Prescribing eyeglasses, contact lenses and other visual aids.
- Prescribing medications and performing minor surgical procedures, as permitted by state law.
- Providing vision therapy or low-vision rehabilitation.
- Providing pre- and post-operative care.
- Screening for diseases such as diabetes and referring patients to other providers.
Read as a set, the duties split into two halves.
The vision-correction half measures and corrects sight: vision tests, refractive errors, glasses and contacts.
The medical half diagnoses and manages disease — glaucoma care, medication, pre- and post-operative care, screening and referral.
BLS flags decision-making skills, communication skills, compassion and being detail oriented as the qualities the work runs on.
The license is what holds the list together.
Every state requires optometrists to be licensed, to take continuing education and to renew periodically, and board certification is optional and separate.
The O.D. degree behind the license is a four-year program.
This page stays on the work itself.
For settings, specialties, pay and the licensing path, the optometrist career guide carries the wider map.
What happens in a comprehensive exam from the OD's side?
Think of the exam in three layers: the data gathered before the OD sits down, the examination and refraction only the optometrist performs, and the decisions that end the visit.
State law decides how much of the first layer moves off the doctor's chair.
The pre-test layer is team work where the state allows it.
Florida's statute lets an optometrist's unlicensed supportive personnel do data gathering, preliminary testing and prescribed visual therapy under the OD's direct supervision — while diagnosis and treatment duties never move to staff.
The middle layer stays with the OD.
Oregon's delegation rule, one worked example of how states write this, reserves — among other tasks — ophthalmoscopy, gonioscopy, final biomicroscopy, final refraction and final tonometry for a glaucoma patient to the optometric physician.
California writes detailed conditions around one delegated task.
There, an assistant may perform preliminary subjective refraction only with at least 45 hours of documented training, while the supervising OD or MD is physically present conducting an in-person exam, and at no more than three assistants per supervisor.
The last layer is why the license exists.
The optometrist turns the exam into a diagnosis, a prescription for glasses or contacts, medication where the state allows it, or a referral when a finding points outside optometry.
How long the exam takes is one question this page leaves open.
Our research did not establish a standard exam length or a patients-per-day figure for optometry, so treat any quoted norm with caution.
What conditions do optometrists diagnose and manage?
On the disease side, BLS names refractive errors and eye diseases such as glaucoma, plus screening for diseases like diabetes with referral to other providers.
Management runs the full ladder: glasses and contact lenses, medication, pre- and post-operative care, vision therapy and low-vision rehabilitation.
Prescribing is the widest-allowed tool — all states allow optometrists to prescribe medication — but the drug list is the state's, not the profession's.
States vary in which medications an optometrist may prescribe.
Texas shows how deep the tiering goes.
A therapeutic optometrist there needs a separate board certificate — a clinical review course plus a board-approved exam — to prescribe oral or parenteral drugs or to treat glaucoma.
The certificate carries the license class optometric glaucoma specialist.
For anyone reading job postings, the practical upshot: the same title can sit on top of different state scopes, so read a posting's duties against the state's law rather than against a national template.
What tasks are delegated to techs and opticians?
Optometrists practice inside a team.
BLS's May 2025 OEWS counted 155,780 wage-and-salary jobs in offices of optometrists (NAICS 621320), and the occupational mix shows who holds them: dispensing opticians 20.49%, ophthalmic medical technicians 14.70%, medical secretaries and administrative assistants 8.91%, receptionists 8.76%, medical assistants 7.10% and optometrists 17.55%.
That is an industry-wide occupational mix, not a per-practice staffing ratio.
What moves off the OD's desk is decided task by task, in state law.
Florida lets supportive personnel gather data and run preliminary testing under direct supervision.
Oregon's rule lets technicians instill medication as instructed, while the final refraction, the final tonometry for a glaucoma patient and the final prescription or treatment decisions stay with the optometric physician.
Alaska law lets an optometrist delegate "routine services of optometry" to an agent who meets board standards, but duties related to pain management and opioid use may not be delegated.
California caps assistant refraction at three assistants per supervisor, with 45 hours of documented training.
Opticians own a different slice of the process: fitting and adjusting eyeglasses and, in some states, filling contact lens prescriptions.
The optometric technician role guide covers the pre-testing, imaging and scribing work in its own right.
Employers staffing around the OD can start from our hiring hub, which maps which roles to fill first, what the pay data says and where to post jobs.
Delegation rules are state rules
How do duties change by setting?
The duty list travels with the license; the weighting changes with the practice.
The vision-correction half — vision tests, refractive errors, glasses and contacts — is the base settings start from, and the medical half is added by the practice's service lines.
OD-MD groups and co-management practices put the surgical-adjacent duties to work.
Pre- and post-operative care is on BLS's duty list, and ophthalmologists perform a wider range of surgeries than optometrists do — the division these groups practice within.
Specialty practices reorganize the day around one line of the same list: vision therapy, low-vision rehabilitation or contact lens practice.
A formal route into that focused work is a residency — one year of advanced clinical training in areas such as primary care, cornea and contact lenses, and ocular disease; residency is optional for licensure.
Retail optical is a different employer structure around the same license.
Costco's optical pages say independent doctors of optometry are located in or next to most Costco warehouses, and Visionworks describes both employed-doctor and subleasing independent-doctor models.
Who holds the contract changes; the OD's duties still come from the state license.
Schedules flex by setting too.
BLS reports most optometrists work full time, part-time work is common, and schedules may include evenings and weekends.
What an optometrist cannot do
The same state license that defines the job draws its limits, and four of them matter in any career decision.
First: no license, no practice.
Every state requires optometrists to be licensed, with continuing education and periodic renewal behind it.
Second: surgery is not part of the license everywhere.
BLS reports that states vary in whether optometrists may perform surgery or other procedures, such as providing vaccinations.
Ophthalmologists, as physicians, perform a wider range of surgeries than optometrists.
Third: lasers.
The American Optometric Association counted Vermont as the 17th state to authorize optometric laser procedures when its law was signed on June 18, 2026, after Kansas and Tennessee earlier in the year.
Two caveats travel with that count.
Vermont's new specialty license takes effect July 1, 2028, and most of Tennessee's provisions start January 1, 2028.
A state can be counted before its optometrists are practicing under the new law.
Even where lasers are authorized, the authorized list can be narrow: Tennessee's law, for one, bars LASIK and PRK, retina procedures, cataract surgery and corneal transplants.
Fourth: the prescription pad is scoped.
All states allow optometrists to prescribe medication, but states vary in which medications that includes.
Even the federal framing stays inside the state's lines — Medicare counts a doctor of optometry as a physician only for limited purposes, and only for services the OD is legally authorized to perform by the state.
None of these lines are fixed.
Scope of practice moves by statute, and a new law can take effect years after it passes, so the limits you train under are the ones your state's board has published today.
Career information, not medical, licensing, billing or legal advice. Licensing and scope-of-practice questions belong with the state board of optometry where you practice or plan to practice.
Scope is state law, and it moves