Urban subspecialty practices lead private equity acquisitions in ophthalmology and optometry
Private equity (PE) acquisitions in U.S. ophthalmology and optometry have declined since peaking in 2021 but remain overwhelmingly concentrated in urban, subspecialty-focused practices, with relatively little investment in rural areas, according to a study.
In this retrospective cross-sectional study, investigators identified 550 PE-backed acquisitions from 2011 to 2024 and classified practices as urban or rural using the Rural-Urban Commuting Area system. Subspecialties were assigned based on company websites, and analyses assessed acquisition volume, geographic patterns, and service offerings.
Overall, 85% of PE acquisitions from 2011 to 2024 involved urban practices. Acquisition activity increased from 2016 through 2021, peaking in 2021, before declining from 71 deals in 2022 to 27 in 2024. During the 2022–2024 period, 96% of acquisitions were urban. Regionally, the South accounted for 50% of recent acquisitions, followed by the West (19%), Midwest (16%), and Northeast (15%), with no statistically significant regional differences (P = 0.19).
Subspecialty analysis showed that retina, oculoplastic, cataract, and optometry services were most commonly offered by acquired practices, particularly in urban areas. Satellite expansion trends are similarly concentrated in urban areas, with urban satellite practices outnumbering rural ones by approximately 3 to 1 (P = 0.03).
Reference
Heider MR, Tian TE, Lee AMet al. Private equity in ophthalmology: geographic trends reveal urban-rural disparities in acquisitions and satellite expansion. Graefes Arch Clin Exp Ophthalmol. 2026;doi: 10.1007/s00417-025-07017-y. Epub ahead of print. PMID: 41533088.
