National comprehensive exam volume grew 6.7% over 3 years—from 4.34 million in 2023 to 4.63 million in 2025—but the annual growth rate was cut nearly in half, dropping from +4.2% to +2.4%. The era of easy growth is ending.
GPN tracked 2,299 US practice locations from January 2023 to December 2025. Here are the key findings:
• National comprehensive exam volume reached 4.63 million in 2025, up 6.7% from 4.34 million in 2023.
• Year-over-year growth dropped from +4.2% (2024) to +2.4% (2025). The growth rate was cut nearly in half.
• Average exams per practice rose from 2,119 (2023) to 2,261 (2025), but per-practice growth is flattening too.
• The difference between +4.2% and +2.4% growth works out to roughly 40 fewer exams per practice per year, or $8,000–12,000 in growth that didn't materialize.
• August and October remain peak exam months nationally, whereas February consistently has the lowest volume.
These data apply to all independent and group eyecare practices conducting comprehensive exams. Practices seeing growth below the national +2.4% average face the most urgency.
Practice Pearl
The headline number, 4.63 million exams, looks healthy—but the trajectory tells a different story. Growth didn't just slow; the rate was cut nearly in half in a single year. The patients who were easy to capture in 2024 have largely been captured. What's left requires more effort: better recall systems, stronger patient retention, and smarter scheduling.
• Run a recall audit this month; identify every patient overdue for a comprehensive exam.
• February is consistently the slowest month nationally. Use it for patient reactivation or staff training.
• Know your number: Calculate your own year-over-year exam growth rate. If you're below +2.4%, you're losing ground.
• Plan staff schedules for August and October, which are consistently peak months.
• Shift from acquisition to retention: Keeping existing patients is more valuable than chasing new ones.
Exam growth is still positive, but the rate is falling. The practices that win in a cooling market are the ones that stop waiting for patients to walk in and start actively managing their exam pipeline.
For the full analysis, visit the GPN Industry Insights blog here.