What PE looks for when acquiring optometry practices

When Private Equity (PE) firms buy an optometry practice, they’re looking for many of the same fundamentals as in dental or other healthcare roll-ups — but with a specific focus on the recurring revenue model, optical retail upside, and platform scalability.

Here’s exactly what PE looks for when acquiring optometry practices or groups:

Top 10 Things PE Firms Look For in Optometry Acquisitions

1. Strong Financial Performance (Especially Optical Revenue)

• EBITDA-driven model: PE is interested in practices with $250K–$1M+ EBITDA

• Solid revenue from:

  • Eye exams (insurance or private pay)

  • High-margin optical sales (glasses, lenses, upgrades)

  • Contact lens subscriptions

  • Ideal: $1.5M–$3M annual collections, 15–25% EBITDA margins

2. High Recall Compliance and Patient Retention

• Recurring exams = stable, predictable revenue

• Well-managed recall process (or potential to implement one)

• Low attrition and strong loyalty = valuable lifetime patient value

• PE loves practices that function like annuity businesses

3. Strong Clinical Team & Transition Plan

• Owner willing to stay on 1–3 years post-acquisition (or assist with transition)

• Associate ODs in place (reduces reliance on a single doctor)

• Solid support staff and optical sales team

4. Efficient, Scalable Operations

• Use of cloud-based or modern PM/EHR (e.g., RevolutionEHR, Compulink)

• Efficient billing and scheduling

• High optical capture rates (>60%) with inventory under control

5. Location & Facility Quality

• Attractive, well-located office(s)

• 3–6+ exam lanes, modern dispensary

• High-traffic retail area or medical plaza = big plus

• Real estate included or long-term lease in place

6. Optical Retail Performance

• High-margin sales: frames, lenses, upgrades

• Capture rate + avg sale per patient are key

• Potential to increase retail sales via branding, merchandising, training

• Optical = big driver of EBITDA and PE loves tangible upsell revenue

7. Growth Potential / Underoptimized Levers

• Weak digital marketing / online presence

• Low recall effectiveness

• No subscription/contact lens auto-ship

• No dry eye clinic or myopia control services

• Opportunity to expand hours, locations, or services

8. Clean Books, Legal & Compliance

• Accurate financials with clear adjustments

• HIPAA compliance, proper credentialing, no ongoing litigation

• Transparent payroll, vendor contracts, and payer mix

9. Platform Potential (Roll-Up Fit)

• Fits geographically or demographically into their DSO/OSO model

• Compatible with their operations model (centralized billing, HR, etc.)

• Referral potential (e.g., retina, ophthalmology integration)

10. Flexible Deal Terms

• PE prefers:

  • Earnouts tied to future performance

  • Partial equity rollover in the larger platform

  • Owner commitment post-close to protect continuity

What Kind of Multiples Are PE Paying in Optometry?

Type	Typical Multiple (EBITDA)
Single location	3–5x
Multi-location (3–5 offices)	5–7x
Platform acquisition or specialty (e.g., vision therapy)	7–10x

Summary: What PE Values Most

Category	Why It Matters
Strong EBITDA + retail margins	Drives returns
Scalable operations	Easier to roll up
Recurring revenue	Predictable growth
Owner retention	Protects transition
Growth levers	Unlocks post-acquisition value