What’s Covered (and What’s Not)

The IRS defines deductible medical expenses broadly in Publication 502, and vision care is explicitly included. But not everything at the optometrist counts:

The 7.5% AGI Threshold — The Real Catch

Here’s where most people lose this deduction: you can only deduct medical expenses that exceed 7.5% of your adjusted gross income. For many people, especially those with employer health insurance, their out-of-pocket medical costs don’t clear this bar.

In this example, the filer had $8,200 in total medical expenses. Only the $2,575 above the $5,625 threshold is deductible — and the glasses and contacts contributed to getting over that line. Use the medical deduction calculator to see if you clear the threshold with your own numbers.

The HSA / FSA Alternative (Often Better)

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you can pay for glasses and contacts with pre-tax dollars — no 7.5% threshold, no itemizing required. For most people, this is a better deal than the Schedule A deduction.

Eligible HSA/FSA vision expenses include: prescription glasses, contacts, contact lens solution, eye exams, and LASIK. If you know you’ll need new glasses this year, it’s worth planning the purchase around your FSA balance before it expires.

Where It Goes on Your Return

Vision expenses go on Schedule A, Line 1 (Medical and dental expenses), combined with all your other qualifying medical costs. The 7.5% calculation happens on Line 3, and only the excess amount carries forward as your deduction.

If you’re self-employed and pay for your own health insurance (including vision), you may be able to deduct the premiums as a self-employed health insurance deduction on Schedule 1 — that’s a different and often more valuable deduction. See the medical deductions guide for the full picture.