Starting a new optometric practice requires significant investment in equipment and technology. The choices you make during this phase will affect patient care quality, operational efficiency, and your practice’s financial health for years to come. This checklist breaks down what you need, what it costs, and how to prioritize your purchases.

For a complete overview of launching your practice, see our guide on starting an optometric practice.

Exam Room Essentials

Every optometry practice needs a properly equipped exam room. These are non-negotiable items that patients expect and clinical care demands.

Primary Diagnostic Equipment

Phoropter and Refractor The phoropter is your primary tool for determining refractive error. Manual phoropters run between $3,000 and $8,000, while digital phoropters with automated features cost $15,000 to $25,000. Digital models speed up exams and reduce technician training time, but manual units work reliably for decades.

Slit Lamp Biomicroscope Essential for anterior segment examination. Basic models start around $2,500, with high-end imaging slit lamps reaching $15,000 or more. Consider your patient volume and specialty focus when choosing. A mid-range model ($5,000 to $8,000) serves most general practices well.

Auto-Refractor/Keratometer These combination units provide objective refraction measurements and corneal curvature data. Budget $8,000 to $20,000 depending on features. The time savings in patient flow often justify the higher-end models within two years.

Tonometer Intraocular pressure measurement is standard care. Non-contact tonometers cost $5,000 to $12,000. Goldmann applanation tonometers run $1,500 to $3,000 plus the slit lamp adapter. Most practices eventually have both.

Retinal Imaging Fundus cameras have become expected rather than optional. Entry-level non-mydriatic cameras start at $15,000. Advanced OCT systems with fundus photography capabilities run $40,000 to $100,000. Consider starting with a basic fundus camera and adding OCT as revenue grows.

Secondary Equipment

Visual Field Analyzer Critical for glaucoma management and neurological assessments. Humphrey-type automated perimeters range from $15,000 to $35,000. If you plan to co-manage with ophthalmology, invest in equipment they recognize and trust.

Lensometer For verifying eyeglass prescriptions. Manual models cost $500 to $2,000. Automatic lensometers run $3,000 to $8,000. The automatic versions integrate better with EHR systems and reduce transcription errors.

Trial Lens Set Always have a backup for phoropter failures and specialty fits. Budget $800 to $2,000 for a complete set with frames.

Optical Dispensary Equipment

If you plan to dispense eyewear, the optical area needs its own equipment investment.

Frame Inventory Starting frame inventory typically requires $15,000 to $40,000 depending on your brand positioning. Premium practices need higher investment. Budget practices can start smaller but need adequate selection to avoid patient frustration.

Edger and Lens Finishing Equipment In-house finishing capability runs $20,000 to $50,000 for quality equipment. Many new practices start with lab partnerships and add in-house capability once volume justifies the investment.

Frame Boards and Displays Professional displays cost $3,000 to $15,000 for a properly merchandised optical area. This is where patient perception of value forms. Cheap displays suggest cheap products.

PD Ruler and Digital Pupillometer Manual PD measurement tools cost under $100. Digital pupillometers with height measurements run $1,500 to $5,000. The digital versions improve accuracy and patient confidence.

Practice Management Technology

Technology infrastructure affects every patient interaction and staff workflow. These systems determine how smoothly your practice operates day to day.

Electronic Health Records (EHR)

EHR systems designed for optometry range from $300 to $800 per month for cloud-based solutions. On-premise systems cost more upfront but may have lower long-term costs for established practices. Key features to evaluate:

The transition cost includes implementation, training, and temporary productivity loss. Budget three to six months for full proficiency.

Practice Management Software

Separate from or integrated with EHR, practice management handles scheduling, billing, and administrative functions. Monthly costs range from $200 to $600 per provider. Look for:

Communication Systems

Patient communication has evolved beyond a receptionist answering calls. Modern practices need:

Phone System VoIP systems cost $20 to $50 per line monthly with features like call routing, voicemail-to-email, and analytics. Traditional phone systems still work but lack flexibility.

Patient Communication Platform Automated appointment reminders, recall messages, and two-way texting cost $100 to $400 monthly. The reduction in no-shows typically covers this expense within the first month.

After-Hours Coverage Patients call outside business hours. How you handle those calls affects both patient satisfaction and revenue capture. Options include voicemail (free but loses patients), answering services ($200 to $500 monthly), or virtual receptionist services that integrate with your practice management system.

Total Investment Estimates

Here is a realistic breakdown of equipment costs for a new optometric practice:

CategoryBudget RangeNotes
Primary diagnostic equipment$40,000 - $80,000Essential exam room items
Secondary diagnostic equipment$20,000 - $50,000Add as specialties develop
Optical dispensary$40,000 - $100,000Varies with positioning
Technology infrastructure$5,000 - $15,000Initial setup costs
Monthly software and services$700 - $2,000Recurring operational costs

Total initial equipment investment typically ranges from $100,000 to $250,000 depending on practice scope and brand positioning.

Prioritization Strategy

Not everything needs to be purchased at once. Here is a suggested priority order:

Phase 1: Opening Day Requirements

Phase 2: First Six Months

Phase 3: Growth Phase

Financing Options

Equipment financing typically offers better rates than general business loans because equipment serves as collateral. Common options include:

Leasing often makes sense for technology that will need replacement within five years. Buying typically works better for equipment with 10+ year lifespans.

Common Mistakes to Avoid

Overspending on opening day You do not need every piece of equipment immediately. Start with essentials and add as patient volume and revenue support expansion.

Ignoring integration Equipment that does not talk to your EHR creates manual work and data entry errors. Verify integration capability before purchasing.

Skipping maintenance contracts Diagnostic equipment requires calibration and service. Budget for maintenance contracts or risk expensive emergency repairs.

Underestimating technology costs Monthly software fees, internet service, IT support, and cybersecurity add up. Budget $1,500 to $3,000 monthly for technology operations beyond initial setup.

Neglecting the optical area The optical generates significant revenue in most practices. A poorly equipped or merchandised optical area limits growth potential.

Next Steps

Equipment selection is one component of launching a successful practice. For guidance on the broader picture including business planning, compliance, staffing, and marketing, review our comprehensive Starting an Optometric Practice 101 guide.

If you are planning a multi-location expansion or need help with patient intake systems, schedule a consultation to discuss how MyBCAT can support your growth.

Last Updated: January 2026

Sources: SBA - Loans, Review of Optometric Business

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