Published in Non-Clinical

Here's What It Cost Me To Open My Optometry Practice Cold

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7 min read

Here you'll find a detailed invoice of what it cost to open my new optometry practice cold.

Here's What It Cost Me To Open My Optometry Practice Cold
How much is opening your optometry practice REALLY going to cost? This article will detail not only the major, but minor costs that oftentimes go forgotten in opening cold.
The true cost of opening an optometry practice varies tremendously. Some things to consider are:
  • size of your venture
  • number of exam lanes
  • equipment needed
  • inventory
  • number of employees
  • and much more
Let’s begin!


This is the first person you need to contact once you decide you are going into business. The cost of setting up the corporation (our business is registered as a PLLC), and costs of dealing with our landlord setting up the terms of our lease cost $1,500.
I am located on the Eastern End of Long Island, so this price may be more or less depending on your location.

Lawyer Cost = $1,500

Rent/building expenses

For this you have to be realistic with whom/what your target is: are you looking to be a chic optical that needs retail space on a main street with a lot of foot traffic? Do you want your optometry practice to be located within a medical building with other medical professionals? Would you prefer to be in a free standing building?
All of these questions will help determine the type of space you need for your optometry practice and how large you need it to be.
Things to be aware of:
  • If any construction needs to be done, who is responsible for the cost? You? The Landlord? What is the estimated timeline?
  • Is anything you build considered property of the building owners (i.e. cabinets, sinks,etc..)?
  • What are the terms of the lease? 1 year, 5 years, 10 years?
  • Watch for percentage rent increase from year to year. We negotiated this out of our contract!
For my partner and I, we decided early on that we were not going to have an optical so foot traffic was not a priority. With that decision our rent option went from $5000/month to about half that.
Keep in mind that you’ll most likely be paying rent before your doors open while you are setting up shop and building out the space. This could be a quick way to be deep in the “red” from the start if you aren’t attentive to how much your rent is! See if you can work out a deal with your landlord to allow you to do work and start paying rent only after you open the business!

Rent Cost = $2,700/month


This is the BIGGEST expense. Hands Down.
There are a lot of ways to save money here; you can do your research and find each individual piece, look into leasing options, scour the internet for sales or purchase from an existing practice that may be closing their doors.
I will be honest here… I did NONE of those things.
With everything else going on, the last thing I wanted to do was spend hours searching for a deal on older/used equipment. I should also mention the way our bank loan was set up, it allowed us to actually buy each piece of equipment up front, so we used a reputable optometric company and purchased all of our equipment from them.
Our office is 1,400 sq feet with a pretest room, one full-exam lane, a shared office, and a room dedicated just to vision therapy. We also have a full-sized, handicap accessible bathroom, a front desk area, and a kitchen/break room.

Here is the list of equipment that we purchased for our everyday use:

Exam Room Equipment:
  • 1 Full Exam Lane (Chair, Stand) & 1 Additional Chair
  • Topcon Slit Lamp
  • Goldmann Tonometer Attachment
  • PC Acuity System
  • Traditional Phoropter
  • Computerized Lensometer
  • Retinal Camera
  • Combination Autrorefractor/Topographer
  • Ocululus Easyfield C Perimeter
  • Handheld Pachymeter
  • Handheld iCare Tonometer
  • Handheld Autorefractor
  • Wheelchair Accessible Electric Table
  • 3 Stools
  • Exam room needs: drops, cotton tip applicators, tissues, alcohol pads, etc.

Equipment Total: ~$105,000*

*Between my partner and I, we had a BIO, lenses (78, 90, 20D, 3 & 4 mirror gonioscopy lenses), stereo and color vision books, occluders, foreign body removal kits, near cards and fixation sticks. If you do not own these things, you are looking at an extra $10-15,000. Add in an OCT or an Optos and you’re looking at over $200,000 alone in equipment costs. My advice is to figure out exactly what you NEED to get your office started, and not just buy everything you WANT.
Vision Therapy Diagnostic Equipment:
  • Development Eye Movement Test (DEM)
  • Beery Visual Motor Integration Test/Score Sheets
  • Test of Visual Perceptual Skills (TVPS)
  • Gardner Reversal Frequency Test
  • Test of Silent Word Reading Fluency (TSWRF)
  • Dyslexia Determination Kit (DDT)
  • Visagraph
  • Primary Mental Abilities (Perceptual Speed/Spatial Relations)

Vision Therapy Diagnostic Equipment Total: ~$2,500

Vision Therapy Equipment:
  • Eye patches
  • Stereo glasses
  • Red/green glasses
  • Brock strings
  • Eccentric circles
  • Vectograms
  • Aperture rule
  • Accommodative flippers
  • Vergence flippers
  • Rotational trainer + tees
  • Marsden balls
  • Red/Green Anti-suppression Charts
  • Red/Green Bar Readers
  • Sherman Cards
  • Parquetry Blocks
  • Geoboards
  • Slant Boards
  • Matrix Cubes
  • VTS 4* (our one splurge !)
  • HTS/PTS Program

Vision Therapy Equipment Total: ~$10,000

If you’re interested in just opening a vision therapy only practice, check out the full article on Creating a Business Plan for Vision Therapy!


Hire a tech guy. S/he'll be your best friend. Seriously. With that said here were some of the items that were required:
  • Server System
  • Computers (7)
  • 42″ TV (2) – waiting room/office for conferences
  • Printers (2)
  • Phones (3)
  • Security Camera System (4)
  • Service Contact for said Tech Guy
  • Electronic Medical Record (EMR) System

Technology Cost = ~$30,000


An essential part to making sure future patients learn about you and know where to find your optometry practice!
  • Logo Design
  • Website Designer/Developer (Check out my website here!)
  • Business Cards
  • Informational Pamphlets
  • Door decal
  • Road Sign
  • Envelopes
  • Letterhead
  • Advertising in local papers, radio stations

Marketing Cost = ~$15,000

Furnishings and miscellaneous

This will vary depending on how large your space is, what work needs to be done, and how you want to decorate. I lucked out and did not have to do major construction except for building our cabinets. Here are some other furnishings to think about:
  • Cabinets
  • Office Chairs (12)
  • Desk (office)
  • Desk Chairs (2)
  • Filing Cabinet
  • Pictures
  • Organizers (Front Desk)
  • Paper, pens/pencils, post-its, stamps, paper-clips, etc...
  • Kitchen equipment: refrigerator, microwave, coffee machine, paper goods
  • Scrubs for employees
  • Phone/Internet Services
  • Garbage removal
  • Heating/Lights

Furnishings/Miscellaneous = ~$50,000

And the grand total . . .

Cost to Open Cold = ~$210,000

Have questions? Comment below!

My hope is that all of you new graduates see the potential of vision therapy, the vast amount of people it can help and how many lives you can change!

Check out these COVD Resources:

  • Learn what COVD has to offer students and residents!
  • Sign up for your FREE COVD membership here!
  • Already a member of COVD? Access programs and benefits here.
  • Come experience the ‘COVD Family’ in person this April–Travel Grants available!
Miki Lyn Zilnicki, OD, FCOVD
About Miki Lyn Zilnicki, OD, FCOVD

Miki Lyn Zilnicki, O.D. graduated with honors from the SUNY College of Optometry in New York, receiving the VSP Excellence in Primary Care and Excellence in Vision Therapy awards. She then continued her education by completing a residency in vision therapy and rehabilitation with Dr. Barry Tannen, OD.

She has extensive experience in family eye care with a specialty and passion for pediatrics, vision training, and neuro-rehabilitation with traumatic brain injury patients. With her partner, she owns Twin Forks Optometry, a specialty care private practice with a focus on vision therapy, rehabilitation, pediatrics, and low vision on the Eastern End of Long Island. In her spare time, she loves cooking and working on the farm with her fiancé.

Miki Lyn Zilnicki, OD, FCOVD
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