How to Become an Optometrist in California: Exams, BreEZe, and TPA

To become an optometrist in California, you need a Doctor of Optometry degree from a program accredited by the Accreditation Council on Optometric Education, passing scores on the national board exams and the California Laws and Regulations Examination, a fingerprint-based background check, and an approved application submitted through the state Board of Optometry’s online BreEZe portal. Plan on about eight years of education and training after high school, plus several months of administrative processing after graduation. Most new optometrists also complete Therapeutic Pharmaceutical Agent and glaucoma certifications, because a basic license alone leaves you with a very limited clinical scope.

Education You Need Before You Can Apply

The California State Board of Optometry accepts one degree: a Doctor of Optometry (O.D.) from an ACOE-accredited school. No other doctorate qualifies.¹

Most students enter an O.D. program after finishing a bachelor’s degree, though some programs will admit strong applicants after three years of pre-optometric coursework. Prerequisites are science-heavy. Expect a full year each of general biology, general chemistry, organic chemistry, and physics with labs, plus biochemistry, microbiology, calculus, and statistics at most programs.

The O.D. program itself runs four years. Classroom work in ocular anatomy, pharmacology, optics, and systemic disease fills the first two years. The final two shift heavily to supervised clinical rotations in primary eye care clinics, hospitals, and specialty practices, where you examine patients under faculty supervision and build up hundreds of documented patient encounters before graduation.

Exams You Have to Pass

California requires two separate testing tracks: the national boards administered by the National Board of Examiners in Optometry (NBEO), and the state-specific California Laws and Regulations Examination (CLRE) administered by the Board.¹

The National Boards (NBEO)

You must pass all three parts of the NBEO plus the Treatment and Management of Ocular Disease (TMOD) section:

Part I (Applied Basic Science) covers anatomy, biochemistry, optics, and visual science. Most students sit for it after their second year of optometry school.
Part II (Patient Assessment and Management) is case-based clinical decision-making, usually taken in the third or fourth year.
Part III (Patient Encounters and Performance Skills) is a hands-on clinical exam at a designated testing center, covering skills like gonioscopy, tonometry, and indirect ophthalmoscopy.²
TMOD is required for eligibility to prescribe therapeutic pharmaceutical agents in California.³

The California Laws and Regulations Examination

The CLRE is a computer-based test on California-specific optometry law. About half the questions cover scope of practice, with the rest split across recordkeeping and reporting, prescribing laws, office management and professional conduct, and advertising and referral rules.⁴ General optometric knowledge is not enough. Preparation means studying the California Business and Professions Code provisions on informed consent, controlled substance prescribing limits, and the rules governing unlicensed assistants.

You cannot walk in and take the CLRE. First you have to create a BreEZe account and submit the Part 1 exam request application, which is how the Board authorizes you to sit for the test.⁵

The Application Through BreEZe

The Board splits the application into two parts. Sending documents in the wrong order stalls the file, so it helps to know what belongs where.

Part 1: Exam Request

Register on BreEZe and submit the Optometrist Initial Exam Request Application (Part 1). Approval clears you to take the CLRE.⁶ The Part 1 fee is $275, plus a $4 National Practitioner Data Bank fee, for a total of $279.⁷

Part 2: License Application

After you pass the CLRE, return to BreEZe for Part 2. At this stage the Board needs:⁵

Official transcripts sent directly from your optometry school, showing the degree confer date. Electronic transmittals from the school are accepted.
NBEO score verification. You instruct the NBEO to release your passing scores for Parts I, II, III, and TMOD to the California Board. Including your OE Tracker number on the application helps the Board match records.
A criminal background check. You email the Board to request a Live Scan form, then take it to a Live Scan site in California to have your prints transmitted electronically to the California Department of Justice and the FBI. Applicants outside California receive hard-card fingerprint forms by mail.

Part 2 fees depend on which certifications you add. The TPA designation is $25. The lacrimal irrigation and dilation designation and the glaucoma designation are $50 each.⁷ These match the statutory caps in Business and Professions Code section 3152.⁸

Once your file is complete, a licensing analyst reviews it. If something is missing, the Board contacts you. Otherwise it approves the application and issues the license. Wall and pocket certificates can take up to 30 calendar days to arrive after approval.⁵ Current processing time estimates are posted on the Board’s website.

TPA and Glaucoma Certification

A plain California optometry license has a narrow clinical scope. To prescribe medications and treat most eye diseases, you need Therapeutic Pharmaceutical Agent (TPA) certification. To treat glaucoma, you need a separate glaucoma certification on top of TPA. Nearly every California optometrist in clinical practice carries both, and most employers assume you will.

TPA certification requires passing the TMOD section of the NBEO and meeting the education standards under Business and Professions Code section 3041.3. With TPA authority you can diagnose and treat conditions like anterior segment infections, ocular allergies, dry eye disease, corneal abrasions, and certain inflammatory disease. Your prescribing authority extends to topical antibiotics, anti-inflammatories, antivirals, antiglaucoma agents (with glaucoma certification), and limited oral medications including short courses of controlled pain medications.

Glaucoma certification adds authority to manage glaucoma patients over age 18. Each certification application fee is $50.⁸ Both certifications also raise the number of continuing education hours you must complete each renewal cycle.

After Your License Issues

The California license clears you to hold yourself out as an optometrist, but a few federal steps sit between licensure and actually seeing insured patients.

You need a National Provider Identifier (NPI) before you can bill insurance or process electronic health care transactions. The NPI is a 10-digit number required under HIPAA, and you apply through the National Plan and Provider Enumeration System at nppes.cms.hhs.gov.⁹

If you plan to prescribe controlled substances, which TPA-certified California optometrists can do on a limited basis, you also need a federal DEA registration. You must have your active California license in hand before applying, and DEA registrations renew on a three-year cycle.

Once you fit contact lenses, the FTC Contact Lens Rule kicks in. You have to give patients a copy of the contact lens prescription immediately after the fitting, whether they ask for it or not. You cannot charge extra for the release, and you cannot condition it on buying lenses from you. If you sell lenses or have a financial interest in their sale, you also need the patient’s signed confirmation of receipt, kept for three years, and the signature has to come after the patient actually receives the prescription, not before.¹⁰

HIPAA’s Privacy, Security, and Breach Notification Rules apply to your practice from day one. California adds patient privacy protections that can be stricter than HIPAA in some areas, and you have to meet whichever standard is more protective.

Keeping the License Active

California optometry licenses renew every two years. The biennial renewal fee is $500, plus a $4 National Practitioner Data Bank fee.⁷ Miss the deadline and a delinquency fee of up to $75 is added on top of the standard renewal.⁸

Continuing education hours track your certifications:

TPA-certified optometrists complete 50 hours of Board-approved CE every two years. At least 35 of those hours must cover diagnosis, treatment, and management of ocular disease, including glaucoma, ocular infection, ocular inflammation, topical steroids, systemic medication, and pain medication with its addiction risks.¹¹
Non-TPA optometrists complete 40 hours every two years, with up to eight hours in patient care management or ethics.¹²

Business management courses do not count under either track.¹² The Board can grant exceptions for military service, health issues, or other good cause, but you have to submit a plan to make up both the current and missed hours.¹¹

CE providers can record your attendance automatically through your OE Tracker number, and the Board accepts OE Tracker transcripts as proof of attendance during audits.¹³

If You Are Already Licensed in Another State

California does not offer automatic reciprocity. Under Business and Professions Code section 3057, an out-of-state optometrist still has to pass the CLRE, meet continuing education requirements, and submit a full application. The main differences are that you do not have to retake the NBEO, and you have to provide extra documentation: proof of good standing in every state where you hold a license, authorization for the Board to pull your National Practitioner Data Bank records and verify your DEA registration if applicable, and confirmation that you have met the TPA certification requirements under section 3041.3. A history of discipline is not an automatic bar, but the Board reviews it and can request more information or deny the application.¹⁴ You also need a Letter of Verification from every state where you hold or previously held an optometry license, sent directly to the California Board.⁵

1
California Board of Optometry. Exam Information for New Applicants
2
National Board of Examiners in Optometry. Part III PEPS Candidate Guide 2026
3
National Board of Examiners in Optometry. National Board of Examiners in Optometry
4
California Board of Optometry. Candidate Information Bulletin Laws and Regulations Examination
5
California Board of Optometry. Frequently Asked Questions – Optometry License Application
6
California Board of Optometry. California Board of Optometry Optometrist Application Process
7
California Board of Optometry. CSBO Optometrist Fees
8
California Legislative Information. California Business and Professions Code 3152
9
Centers for Medicare and Medicaid Services. How to Apply
10
Federal Trade Commission. The Contact Lens Rule – A Guide for Prescribers and Sellers
11
California Legislative Information. California Code BPC 3059
12
Legal Information Institute. California Code of Regulations Title 16 Section 1536
13
Association of Regulatory Boards of Optometry. OE TRACKER
14
California Legislative Information. California Business and Professions Code 3057