Tax Planning for Ophthalmologists (2026)

By GenWealth 360 Editorial TeamPublished October 27, 2026Updated October 27, 2026

Ophthalmologists often run equipment-intensive practices with ASC ownership and cash-pay refractive services.

Tax planning priorities for ophthalmologists

Equipment

Lasers and diagnostic equipment can often be expensed through Section 179 or bonus depreciation.

ASC ownership

Track participation for passive activity and NIIT purposes.

Optical shops

Retail optical sales involve inventory and, in many states, sales tax.

Exit

Ophthalmology has seen PE roll-ups; plan the deal structure early.

Strategies that apply to every specialty

Know your marginal rate. In 2026 the 37% federal bracket starts at $640,600 (single) and $768,700 (joint); see how much tax doctors pay.
Fill every tax-advantaged account: 401(k)/403(b) ($24,500 in 2026), 457(b), HSA and a backdoor Roth.
Match the plan to how you are paid: W-2, 1099 or practice owner.
Use your state's rules; see our 50-state guides.

Frequently asked questions

Can an ophthalmology practice expense a new laser?

Generally yes, under Section 179 or bonus depreciation, subject to limits and state conformity.

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Related guides

Tax Planning for Medical Practice OwnersTax planning for private practice physicians and medical practice owners: entity structure, owner compensation, retirement plan design, the PTET, real estate ownership, buy-ins and preparing for a sale.Tax Deductions for Physicians: What Doctors Can and Cannot Write Off in 2026A 2026 list of tax deductions and write-offs for physicians: what W-2 doctors can deduct, what 1099 physicians and practice owners can deduct, and common deductions doctors miss.Taxes When Selling a Medical Practice: Private Equity, Hospitals and Physician BuyersHow to reduce taxes when selling a medical practice to private equity, a hospital or another physician: asset vs. stock sales, goodwill, rollover equity, earnouts, installment sales and state residency.

Sources

This article is for general educational purposes and is not tax, legal or investment advice. Tax law changes often and its application depends on your facts. Figures reflect 2026 rules as published by the sources listed above. Consult a qualified professional before acting. See our editorial policy.