I'm actually up from last year, netting higher per month. But I'm very nervous all the time about the economy. Insurance is becoming more heavily dominate. Get on all the best insurances as possible, then weigh the decision on the crappy ones if they are worth taking. My state Medicaid will pay up to about a $105 for a new patient exam, whereas Eyecrap (Eyemed) will pay only $40.
I live in the Mid-west, and so far it hasn't hit too hard yet. I think it will be more challenging this year for new grads.
there have been a number of smaller lasik places entering bankruptcy protection. Cataract has been stable, by and large its a procedure that people use their medicare for, and have little out of pocket expense. However, I could imagine there are fewer people upgrading to premium IOL's.