Side by side
| Optometrist | Ophthalmologist | |
|---|---|---|
| Degree | Doctor of Optometry (O.D.) | M.D. or D.O. |
| School after college | 4-year O.D. program | 4 years of medical school |
| After that | Optional 1 year of advanced clinical training | Internship and residency |
| License | State license, all states | State medical license, all states |
| Median pay (BLS, May 2025) | $136,570 | $300,080 |
| Median hourly | $65.66 | $144.27 |
| Employed in the U.S. | 42,790 | 8,950 |
| Projected growth, 2025–35 | 9.5% | 4.5% |
| Typical entry education (BLS) | Doctoral or professional degree | Doctoral or professional degree |
Who earns more in your state
What each one does
Optometrists examine eyes and treat disorders of the visual system, often as the first stop for vision care. Ophthalmologists are medical doctors, so their training also covers surgery and treating eye disease as physicians.
For a routine exam or new glasses, an optometrist is the usual choice. Decisions about your own eye care belong with a clinician who has examined you.
The training gap
Both typically start with an undergraduate degree. From there, an optometrist needs a 4-year O.D. program, while an ophthalmologist needs medical school plus residency. The BLS puts internship and residency across specialties at 3 to 9 years.
Different workplaces
Most optometrists (64%) work in offices of other health practitioners, at a median of $129,250. Most ophthalmologists (75%) work in physicians' offices, at $303,920. Outpatient care centers are a high-paying niche for both: $207,030 for optometrists and $458,580 for ophthalmologists, though few of either work there.
Optometrists are about five times as numerous, 42,790 against 8,950. The BLS projects about 2,000 openings a year for optometrists and 200 for ophthalmologists, with growth of 9.5% and 4.5%.
How the pay ranges compare
Ophthalmologist pay varies widely, from $100,180 at the 10th percentile to $489,710 at the 90th. Optometrists range from $74,870 to $202,180.
Exact medians exist for both in 34 states. The gap is largest in Rhode Island ($450,370 against $134,520). Optometrists come out ahead in 1 of those states: Kentucky, at $128,860 against $101,940. With so few ophthalmologists in some states, single-state numbers can be volatile.
Questions people ask
Is an optometrist a doctor?
An optometrist holds a doctoral degree, the O.D., but is not a physician. An ophthalmologist is a physician.
Who earns more?
Ophthalmologists. The national medians were $300,080 and $136,570 for optometrists in May 2025.
What exam do optometry applicants take?
Applicants must take an entrance exam covering natural sciences, reading comprehension, physics and quantitative reasoning.
Sources
General information, not career advice. Scope of practice and licensing differ by state: confirm them with your state board.