Research
October 2026 snapshot: who held page one in 14 towns
One search phrase, "eye doctor [town] [state]", run once in each of 14 towns on October 21 and 22, 2026, from a desktop browser, signed out, with every first-page result classified by who held it. It cannot tell you how your own town looks: results vary by device, by exact location and by the hour, and this is two days in October. Below that, a smaller look back at eight practices and background on the market.
Method
Fourteen towns, one search each, typed the way a patient types it.
We picked 14 county seats and mid-size towns in 14 states, the kind of place an independent practice serves: Tyler, Texas; Joplin, Missouri; Bowling Green, Kentucky; Grand Junction, Colorado; Dothan, Alabama; Hattiesburg, Mississippi; Bend, Oregon; Muncie, Indiana; Yakima, Washington; Lafayette, Louisiana; Johnson City, Tennessee; Rapid City, South Dakota; Florence, South Carolina; and Sioux City, Iowa. In each we searched "eye doctor [town] [state]" in a desktop browser 1,366 pixels wide, signed out of any Google account, with English and United States settings, from Austin, Texas, leaving the search location to Google.
For each results page we recorded whether an AI Overview appeared, how many businesses with a star rating the map pack listed, how many organic web results the first page carried, and what kind of site held each of those results: the website of an individual local practice, a directory or review site, a chain-branded optical's location page, or a hospital or health system's page. We did not count text ads, because Google shows them unevenly to a signed-out browser and an absence proves nothing. We did not record any business's name for publication, and none appears here.
This is a snapshot. Results change by hour, by device and by exact location, and a patient standing in the town sees a map pack weighted to where they stand. Fourteen searches say what the page looked like on two days in October 2026. They do not say how it trends.
Findings
Local practices held 82 of 122 first-page spots. Yelp held one in every town.
The map pack appeared in all 14 towns. Below it, the first page carried between 7 and 9 organic web results, 122 in all. Websites of individual local practices held 82 of them, an average of 5.9 per town and never fewer than 4. Directory and review sites held 16, with Yelp present in every town and a second directory in two. Chain-branded optical location pages held 10, appearing in 9 of the 14 towns and never more than twice in one. Hospital, health-system and clinic pages held 14, in 11 towns.
- Local practice websites
- Yelp and directories
- Chain-branded optical pages
- Hospital, health-system and clinic pages
- Local practices
- Yelp and directories
- Chain pages
- Hospital pages
The map pack showed fewer than three rated businesses in half the towns.
People picture the map pack as three businesses. It showed three rated businesses in 7 towns. In 4 towns it showed two, and in 3 towns (Bowling Green, Yakima and Johnson City) only one listing carried a rating at all. A listing without a rating can still rank; what the count says is that in those towns the pack had room, and the second or third slot was held by a profile with no reviews or by nothing we could classify as a practice.
No AI Overview appeared on any of the 14 searches.
Google did not show an AI Overview for "eye doctor [town]" in any town. That matches Whitespark's May 2025 study of 540 local searches in Houston, Phoenix and Denver, optometry searches included: AI Overviews appeared on 15 percent of local-intent searches and on 92 percent of informational questions, while the map pack appeared on 93 percent of local-intent searches and 6 percent of informational ones. A search with a town in it is a request for a practice.
The table scrolls sideways on a phone.
| Town | AI Overview | Rated map listings | Web results | Local | Directories | Chain | Hospital |
|---|---|---|---|---|---|---|---|
| Tyler, TX | no | 2 | 9 | 6 | 1 | 1 | 1 |
| Joplin, MO | no | 3 | 9 | 6 | 1 | 1 | 1 |
| Bowling Green, KY | no | 1 | 9 | 5 | 1 | 1 | 2 |
| Grand Junction, CO | no | 2 | 9 | 5 | 2 | 1 | 1 |
| Dothan, AL | no | 2 | 7 | 6 | 1 | 0 | 0 |
| Hattiesburg, MS | no | 3 | 7 | 4 | 1 | 1 | 1 |
| Bend, OR | no | 3 | 9 | 8 | 1 | 0 | 0 |
| Muncie, IN | no | 3 | 9 | 5 | 1 | 1 | 2 |
| Yakima, WA | no | 1 | 9 | 7 | 1 | 0 | 1 |
| Lafayette, LA | no | 3 | 9 | 7 | 1 | 0 | 1 |
| Johnson City, TN | no | 1 | 9 | 4 | 1 | 2 | 2 |
| Rapid City, SD | no | 3 | 9 | 6 | 2 | 0 | 1 |
| Florence, SC | no | 3 | 9 | 6 | 1 | 1 | 1 |
| Sioux City, IA | no | 2 | 9 | 7 | 1 | 1 | 0 |
| 14 towns | 0 of 14 | 32 of 42 | 122 | 82 | 16 | 10 | 14 |
The town-by-town record. "Local" is the websites of individual practices (a few are regional multi-office groups). "Chain" is a chain-branded optical's location page. "Hospital" is a hospital, health-system or clinic page.
Five years backA smaller sample, October 2026
Four of eight independent practices had lost a third or more of their ranked searches since 2021.
Separately, we looked at eight independent optometry practices in four of the towns above (Tyler, Joplin, Bowling Green and Grand Junction) using a third-party estimate of how many searches each practice's website ranks for, and compared the count today with the count five years ago. A practice counts as having lost ground when a third or more of those rankings are gone. Four of the eight had. In three of the four towns, a chain-branded optical was running Google ads on the searches we looked at.
Eight practices is not a study, and we do not treat it as one. The published trend in optometry is in ownership and in where glasses are bought after the exam: the Vision Council's Q4 2025 survey put more than 60 percent of exams at independent practices and the Q1 2026 survey said they remain the main setting. A practice that is losing rankings is not losing patients yet.
BackgroundThe market around the independent practice
Exams stayed with independent practices. Ownership and eyewear moved.
The Bureau of Labor Statistics counted about 45,100 optometrist jobs in 2025, 61 percent of them in offices of optometrists, and the AOA says 39 percent of US counties have an optometrist but no ophthalmologist. The share of optometrists working mainly in private practice fell from 75 percent in 2009 to 58 percent in 2015, according to the AOA's own surveys, and an AOA workforce study found employed ODs rose from 29 percent to 44 percent of the profession between 2012 and 2017. By 2022, one optometrist's count put 16.5 percent of US ODs under private equity-backed groups, up from 6.6 percent in 2018, and at the end of 2024 the four largest consolidators ran 869, 671, 475 and more than 260 practices each.
The Vision Council's Q4 2025 survey put more than 60 percent of exams at independent practices, and 78 percent of people examined in the last three months of 2024 bought their eyewear from the same provider. In the first quarter of 2026, fewer patients bought eyewear where they were examined. Contact lens purchases at corporate and chain locations ran at 62 percent in the second quarter of 2026, and between 33 and 40 percent of contact lens purchases were online in each quarter from mid-2024 to early 2025; online sellers may rely on the Contact Lens Rule's eight-business-hour passive verification.
Insurance steers the first choice. In the Vision Council's 2024 consumer study, 77 percent of adults rated in-network status important when choosing a provider, and 72 percent did not ask for a specific doctor. On Zocdoc's 2024 eye care bookings, 90 percent of patients picked an in-network provider.
What it meansFor one practice
What the snapshot suggests for one practice
In 13 of the 14 towns, local practice websites held most of the first-page web results for "eye doctor"; in the other, Johnson City, they still held the largest share (4 of 9). Chain-branded opticals took at most two spots in any town. An independent practice is competing with the other practices in town for the three map slots and the top of the web results, and with Yelp for the patient who clicks a review site first.
Google ranks the map mainly on three things, by its own account: relevance (the profile and the pages behind it), distance (where the patient is), and prominence (links and reviews). Chains can buy ads, including spots on Google Maps, but no one can pay Google for a better ranking in the map results; the help page says "there's no way to request or pay for a better local ranking." In our four-town look back, chains were running ads in three of the four towns, and in half of the 14 towns the map pack showed fewer than three rated businesses.
If you want to know how your practice reads on this page for your own town, the free ranking check does exactly this, for ten searches, with your practice and the practices above you named to you and to nobody else. The sample report shows the format.
Sources
- Our own searches, October 21 and 22, 2026, as described above. The raw results are kept on file and never published with business names.
- Google Business Profile Help, "Tips to improve your local ranking on Google", support.google.com/business/answer/7091.
- Whitespark, "The prevalence of AI Overviews in local search", May 12, 2025, 540 queries in Houston, Phoenix and Denver, optometry searches included, whitespark.ca.
- The Vision Council, Consumer inSights Q4 2025 (12,129 US adults) as reported by Vision Monday, January 21, 2026, and Q1 2026 (12,031 adults) as reported May 1, 2026.
- Bureau of Labor Statistics, Occupational Outlook Handbook, Optometrists, last modified August 27, 2026, bls.gov; AOA state advocacy page, aoa.org.
- Optometry Times, "How private equity affects optometry", May 8, 2019 (AOA data); Review of Optometry, "Profit and loss", June 15, 2021 (AOA workforce study); Richard Edlow, OD, Review of Optometric Business, July 27, 2022; Vision Monday consolidator roundup, April 2025.
- Eyecare Business, January 23, 2025 (Consumer inSights Q4 2024) and November 7, 2024; Optometry Times, April 22, 2025; Vision Monday, September 9, 2026 (Consumer inSights Q2 2026); 16 CFR 315.5.
- Vision Expo Daily, February 22, 2025 (Focused inSights 2024: Consumer Choices); Zocdoc, "What eye care patients wanted in 2024".