Updated: June 2026
Published by Physician Growth Partners
Over the last few several years, the ophthalmology industry has experienced significant changes with respect to private equity and related M&A activity. While a select number of PE-backed ophthalmology platforms and eye care management organizations (MSOs) remained active acquirers, many groups paused M&A to shift their focus inward – taking meaningful steps to strengthen their existing operations. Rather than pursuing aggressive acquisition strategies amid uncertainty created by rising interest rates and broader market conditions, many ophthalmology platforms shifted focus toward integrating after years of heavy acquisition activity, improving operational efficiency, organic provider recruitment, and rightsizing their organizations to optimize margins and strengthen financial position.
However, beginning in 2026, many ophthalmology MSOs and private equity-backed eye care platforms resumed their acquisition activity. The renewed interest in M&A was accelerated by the entrance of strategic buyers into the sector in 2025, highlighted by McKesson’s acquisition of Prism Vision Group and Cencora’s acquisition of Retina Consultants of America. These transactions signaled a growing level of confidence in the ophthalmology market and introduced a new class of well-capitalized buyers.
As acquisition activity is increasing and the buyer universe expanding, independent ophthalmology practices now have access to a broader range of strategic and financial partners than ever before. This evolving landscape has created additional transaction outcome opportunities and provided practice owners with greater flexibility as they evaluate potential partnership, recapitalization, or sale alternatives.
Ophthalmology in the United States remains a highly fragmented specialty, with an estimated 18,000+ practicing ophthalmologists operating across a mix of physician-owned group practices, hospital-affiliated models, academic centers, pharma distributors and private equity–backed platforms. 1 Despite growing consolidation activity over the past decade, a meaningful portion of the specialty continues to operate in independent or semi-independent structures, with 47.4% of practices operating with fewer than 10 physicians. 2
This fragmentation exists against a backdrop of steadily increasing demand for ophthalmic services driven by an aging population and rising incidence of chronic eye disease, including cataracts, glaucoma, and retinal disorders. At the same time, independent practices face ongoing structural pressures, including reimbursement compression, wage and supply inflation, increasing capital requirements for advanced diagnostic and surgical technologies, and competitive pressure from both hospital systems and scaled multi-site platforms. The benefits of joining a larger platform remain highly compelling in the current environment, as practices can create value through economies of scale, expanded clinical capabilities, centralized back-office support, and enhanced operational efficiencies. These dynamics continue to drive buyer interest in high-quality ophthalmology practices and platforms.
The ophthalmology sector was among the earliest physician practice management (PPM) specialties to experience meaningful consolidation. Between 2015 and 2020, private equity activity was primarily focused on establishing platform companies and building foundational infrastructure. As these platforms matured, M&A activity accelerated through 2022, driven by strategic add-on acquisitions and geographic expansion initiatives aimed at increasing market density, enhancing scale, and creating leading regional and national eye care organizations. EBITDA multiples in the ophthalmology sector were among the highest across the physician practice management landscape.
However, between 2023 and 2025, with interest rates increasing, acquisition activity slowed considerably as many ophthalmology platforms shifted their focus inward, prioritizing operational improvements, integration efforts, and organizational optimization over external growth initiatives. As a result, valuation multiples contracted meaningfully, with transaction valuations generally trading approximately 2–3 turns below peak levels.
However, in 2025, the buyer pool expanded with the entry of pharmaceutical distributors and other strategic healthcare services companies pursuing vertical integration within high-value subspecialty segments. Notable transactions, such as Cencora’s $4.6 billion acquisition of Retina Consultants of America and McKesson’s acquisition of Prism Vision Group, highlight the strategic value of scaled ophthalmology and retina platforms and underscore continued interest from large healthcare distribution and services players. In 2026, Cencora doubled down on its retina thesis, acquiring the retina division of EyeSouth Partners.
As the buyer universe continued to expand and private equity-backed ophthalmology groups resumed their acquisition efforts, independent ophthalmology groups gained access to a wider array of exit and recapitalization alternatives. This evolving landscape created additional liquidity pathways, contributing to a gradual recovery in valuation multiples toward historical levels.
Valuations within the ophthalmology sector are heavily influenced by four primary drivers: ancillary infrastructure, scale, revenue composition, and geographic footprint. Scaled and sophisticated groups are achieving premium valuations in the high-single to low-double-digit EBITDA multiple range, while smaller practices operating below $3 million in EBITDA generally transact in the mid to high single digits. The single most impactful value driver is ancillary infrastructure, most notably ASC ownership. Practices that own or operate surgery centers typically generate higher margins and more diversified revenue streams, making them more attractive to investors and often resulting in higher EBITDA valuation multiples than clinic-only practices. Additional ancillary services that buyers find attractive, including refractive services, diagnostic testing, optical dispensaries, and medical aesthetics, can enhance a platform’s margin profile and overall valuation.
Buyers place a premium on larger, higher-EBITDA practices with greater provider density, as scale signals operational maturity, reduced key-person risk, and a platform capable of supporting continued growth. Revenue composition has also become an increasingly important consideration, with subspecialties such as glaucoma, oculoplastic, and particularly retina commanding greater attention. The growing interest from large pharmaceutical distributors and other strategic buyers has elevated the strategic value of retina-focused practices within the ophthalmology sector.
Geographic footprint complements these dynamics, with multi-site platforms in attractive or undersupplied markets typically achieving enhanced buyer interest and competitive tension.
The ophthalmology buyer universe consists of several distinct acquirers:
| Date | Buyer | Target | Commentary |
|---|---|---|---|
| Jan 2025 | Sight MD | Doctor & Associates | Comprehensive ophthalmology practice in Fairfield County, CT. |
| Jan 2025 | Cencora, Inc. | Retina Consultants of America | Retinal subspecialty national MSO spanning a nationwide physician network. |
| Mar 2025 | Eye Health America | Eye Center of Central Georgia | Comprehensive ophthalmology practice and ASC in Macon, GA. |
| Mar 2025 | EyeSouth Partners | Retina Institute of Illinois | Retina subspecialty practice in Illinois. |
| Apr 2025 | McKesson Corporation | PRISM Vision Holdings | Multi-specialty eye care MSO. |
| Jun 2025 | Vision Innovation Partners | Eye Care of Delaware | Eye surgery and related treatments practice serving the Mid-Atlantic. |
| Jul 2025 | ReFocus Eye Health | New View Eye Center | Laser and specialty eye care practice in the greater Washington, DC area. |
| Jul 2025 | EyeSouth Partners | St. Lucie Eye | Comprehensive ophthalmology practice in Florida. |
| Sep 2025 | EyeSouth Partners | Katz Eye Center | Ophthalmology practice in Florida. |
| Dec 2025 | PRISM Vision Group (McKesson) | Spokane Eye Clinic | Multi-site, comprehensive ophthalmology group practice; flagship asset in the Northwest. (Advised by PGP) |
| Jan 2026 | Ascend Vision Partners | Oklahoma Retinal Consultants | Retina subspecialty practice located in Oklahoma City. |
| Jan 2026 | Ascend Vision Partners | Wise Eye Associates | Comprehensive ophthalmology practice based in Norman, OK. |
| Jan 2026 | Ascend Vision Partners | Sylvester Eye Care & Aesthetics | Comprehensive ophthalmology and aesthetics practice in Oklahoma City. |
| Feb 2026 | Vision Innovation Partners | Ophthalmic Associates of Alexandria | Comprehensive ophthalmology practice in downtown Alexandria, VA. |
| Mar 2026 | Cencora, Inc. | EyeSouth Partners | Acquisition of EyeSouth’s retina business; affiliated retina physicians of EyeSouth. |
Client Advised by PGP
PGP is one of the most active advisors in the ophthalmology sector and has represented seventeen (17) independent eye care groups in transactions with private equity and strategic buyers over the years.
A few notable PGP transactions are as follows:
With firsthand experience to inform our thinking, PGP believes that it’s a great time to evaluate a potential transaction given the following factors:
Premium Valuation Environment: Ophthalmology valuations have strengthened considerably over the past year, supported by improved capital market stability, a highly competitive buyer landscape, broadened buyer universe and a growing number of well-capitalized platforms actively deploying capital in advance of anticipated recapitalizations.
Increased State Restrictions: State legislature has continued to impose stricter rules on investors and strategic buyers seeking to invest in the provider sector. Recent policy changes in Oregon and California have added new limitations and increased reporting requirements, prompting many investors to avoid or reduce exposure to these states. Physician Growth Partners (PGP) believes that additional states are likely to adopt similar restrictions and reporting obligations in the future.
A Tightening Reimbursement Environment: Medicare reimbursements have declined more than 30% in inflation-adjusted terms since 2001, while practice operating costs have continued to rise. This has created a widening financial gap, leaving independent ophthalmology groups increasingly challenged to offset persistent margin compression. 4
Substantial Institutional Dry Powder: Private equity investors and strategic consolidators entered 2026 with significant reserves of uncommitted capital to deploy. This liquidity ensures a deep bench of extremely motivated buyers, protecting the ophthalmology sector from broader macroeconomic credit tightening and sustaining transaction volumes.
Despite increased scrutiny of private equity’s role in healthcare, not all investors operate the same way. Many ophthalmology platforms have evolved their governance structures to preserve physician autonomy and clinical independence while focusing on operational improvements such as payor contracting, purchasing efficiencies, ancillary service expansion, and strategic growth. As a result, independent practices should carefully evaluate potential partners rather than relying on public perception alone.
At the same time, the ophthalmology M&A market remains highly favorable for practice owners. Competition among buyers is strong, capital remains abundant, and both established platforms and new investors continue to pursue high-quality ophthalmology groups. The MSO model has matured and demonstrated that institutional partnerships can provide operational scale, enhanced recruiting capabilities, and revenue growth opportunities without compromising clinical decision-making. Combined with ongoing reimbursement pressures and administrative burdens, today’s market offers independent ophthalmology practices a compelling opportunity to explore strategic partnerships from a position of strength, supported by competitive valuations and significant hindsight to evaluate track records of partners.
While valuation is an important consideration, selecting the right partner extends far beyond the numbers. Practices should prioritize finding an organization that aligns with their culture, values, long-term vision, and approach to patient care, as cultural fit is often the most critical factor in building a successful long-term partnership.
No obligation. Completely confidential. Typically 30 minutes.
Sources & Citations
Physician Growth Partners · This content is provided for informational purposes only and does not constitute legal, financial, or investment advice. All transaction data sourced as cited. © 2026 Physician Growth Advisors, LLC. All rights reserved.