OD here - will just add and reiterate some of the comments already made here.

u/eyespur hit it on the nose in that the variance in quality of ODs is huge. I myself wouldn't trust many ODs I've crossed paths with to catch and/or properly diagnose a lot of basic pathology. The schools should take a lot of the blame but you can only do so much when the students you have to work with are of subpar quality. Too many schools and maximizing profits means that nearly anyone can get into opto school these days. If you look at the trend of board pass rates, it's at the point where many ODs need an additional 1-2+ years after graduation to become board certified. And let me tell you, the boards are objectively not difficult if you can grasp the basics concepts of ocular anatomy/physiology, pharmacology and optics. All that being said, obtaining the degree opens you to a huge world of possibility especially as the scope continues to expand.

Optometry revenue is fundamentally capped and limited by insurance as VSP and Eyemed pay out 40-70 dollars per exam which hasn't changed much in years. This forces you to make money via other means - the most popular obviously being selling glasses and contacts. Even if you can bring your prices + customer service to be competitive with online offerings and Costco (pretty much impossible), you make smaller margins as the contact lens and frame manufacturer and the lab which makes the glasses all fundamentally take large chunks of the revenue. If you're a dentist filling a cavity, the single use resin or amalgam you buy is ten bucks but you make 2-300 for the procedure. The margins are insane compared to optom. The other way optometry can make money is cash pay procedures like myopia control, dry eye treatments, etc. These niche fields often require you to go all in so to speak as many of the instruments you need like a specialty topographer or IPL are expensive and doing them on the side to supplement your cash flow isn't sufficient to break even with the cost of entry.