How States Count Years of Practice for Optometry Endorsement

When a state licenses optometrists by endorsement, it is usually asking one question: have you been practicing, recently and at the right level? The answer is a number of years, but the number is the least of it. Boards differ on the window they look back over, whether the years must be continuous, which kinds of work count, whether practice at a lower scope tier counts at all, and what proof they will accept. An optometrist with ten years in practice can still fail a three-year rule if the last year was spent teaching in the wrong state.

What does each state require?

From the verified state facts behind our state pages. "Endorsement" here includes routes a state calls reciprocity.

Several states set years only on an alternative route: Minnesota's paper endorsement (three years), Pennsylvania (four years immediately before applying, as an alternative to passing all of NBEO), South Dakota (five consecutive years), Oregon (two continuous years, for optometrists who passed TMOD before 2002), Texas's License without Examination (five of the last seven, for pre-1994 licensees) and New York's endorsement (five years in the last ten, for optometrists licensed without NBEO). If you hold the NBEO parts those states require, the years never come up; see states that license without years of practice.

Does "immediately preceding" mean what it says?

Yes, and it is the part of these rules that catches people. Kansas, Maryland, Massachusetts and Ohio count the years right before you apply, so a gap last year can sink an application even with decades of earlier practice. Massachusetts and Nevada also want them continuous. "X of the last Y" rules, used by Arizona, Arkansas, Florida, Georgia, Nebraska and West Virginia, are more forgiving: Florida's two of four lets you have been out of practice for up to two of those years. Delaware's rule is different again, five years in any single jurisdiction where you hold a current license, which helps someone who practiced long in one state and recently moved.

Which kinds of work count as practice?

Boards define it more narrowly than most optometrists expect.

• Scope level. Alaska counts only hours "at the highest therapeutic level" authorized where you practice. Ohio's three years must include therapeutics. Missouri wants practice with pharmaceutical certification, and South Carolina therapeutic-level practice with authority to treat glaucoma. Years practiced under a diagnostic-only license may not count.
• Teaching and other roles. Maryland lets teaching, uniformed service, supervisory and research years count. Texas's License without Examination accepts full-time teaching at an accredited college of optometry or medicine in place of therapeutic practice.
• Continuing education. Maryland also wants the CE the other state required for those years.
• Licensure versus practice. Utah measures one year of holding an equivalent license, not practice. Ohio's Chapter 4796 route defaults to one year of licensure plus practice in one of the last five years.

How do boards want the years proven?

Usually by someone other than you. Alaska wants the 3,120 hours on an affidavit signed by a licensed health care professional who knows your practice. Delaware wants practice verification letters from someone who knows your history, such as an employer, colleague or accountant. Nebraska accepts W-2s or an employer or partner letter. Texas asks License without Examination applicants to list dates of therapeutic practice or teaching for every state and has each state's board fill out a Texas verification form. Self-employed optometrists should plan for this early, since a letter from an accountant who knows the practice may be the most practical third-party proof.

How do the same years look to different states?

Take an optometrist who practiced full time at the therapeutic level in one state from 2015 through mid-2024, then spent two years teaching full time at a college of optometry, and applies in mid-2026.

• Florida (two of the last four years): the four-year window starts in mid-2022, and it holds about two years of clinical practice, so the rule is met only if the board counts those years in full. It is close enough to check carefully.
• Georgia and West Virginia (five of the last seven): the seven-year window starts in mid-2019 and holds about five years of practice, so this optometrist meets the count, with no margin.
• Maryland (three years immediately before applying): teaching years can count there, so the last two years are not a gap.
• Kansas and Massachusetts (three years immediately before applying): the most recent years were teaching, not practice, so the rule is not met unless the board treats teaching as practice.
• Texas License without Examination (five of the last seven): therapeutic practice and full-time teaching both count, so all seven years do, for an optometrist eligible for that route.

The same career passes in some states and fails in others, entirely on the board's window and definition. That is why the counting has to happen state by state, before you pay any fee.

What if you fall short?

1. Use a scores route if the state has one. Pennsylvania, Minnesota, Missouri, Wisconsin and South Dakota all offer one alongside their years-based routes.
2. Look for an alternative proof. Iowa takes 2,080 practice hours in the past two years, but also a CELMO certificate, a year of faculty work, 50 CE hours or a recent NBEO pass.
3. Use the state's fallback. Kentucky sends optometrists with fewer than five years to its standard application, which needs NBEO parts passed within five years. Delaware's fallback is a six-month board-approved internship.
4. Wait, if the gap is small. A rule that counts years immediately before applying gets easier every month you practice. Your application date matters, so plan it.

Our guide to choosing between endorsement and NBEO scores and the out-of-state licensing hub explain the other routes.

How does the readiness review handle years?

We build a month-by-month practice history from your records, mark which months count for each target state given its window, scope level and definition of practice, and tell you which states you qualify for today and which date you would qualify in the rest. The review is $149, credited in full toward a first application; a license on NBEO scores or by endorsement is $699 per state, and $799 where the state adds an interview, such as Arkansas or West Virginia. See pricing or the state license index.