Most of an optometry practice's Google Ads account is built on purpose: the tracking, the keywords, the bids, the ads. Then comes a screen full of settings that most people click through, and Google's defaults quietly decide a lot. One of them lets Google write your ad text for you, using words it finds on your own website.
For most businesses that's a convenience. For an eye care practice it can be a liability, because some state optometry boards restrict what an ad may claim, and Google's writer doesn't know your state's rules. This chapter covers the settings we change on every new optometry campaign before it spends a dollar, starting with that one.
New Search Campaigns Start With Google Writing Text
When you create a new Search campaign, Google switches on AI Max for it automatically, and the option arrives already selected. Among AI Max's features is text customization, the feature Google used to call automatically created assets. Google began moving it into the AI Max settings under the new name on May 26, 2025.
Here's how Google describes the way it works. Text customization pulls short pieces straight from your pages (the page title, the meta description and other page tags) and combines them with generative AI that's grounded in your landing page's content. It then writes new headlines and descriptions for searches you didn't anticipate, and Google says it reviews and refreshes those assets at least every 48 hours.
In plain terms: Google reads your website and writes ad lines from it, continually, without asking you to approve each one.
Your Own Page Title Can Hand Google a Line Your Board Bans
The risk isn't that Google invents a wild claim out of nowhere. It's that your own website already contains one, and Google's writer turns it into a headline.
Plenty of practice websites carry marketing language in their page titles and meta descriptions: "Top-Rated Eye Doctor," "Best Optometrist in Town," "The Area's Leading Eye Care." Visitors rarely see that text on the page itself, but it's exactly the kind of snippet text customization is built to lift.
As Chapter 8 covered, some states restrict those claims. Illinois, our example market's state, outlaws superiority claims by optometrists outright, the rule quoted in Chapter 8. An ad headline reading "Best Eye Doctor in Town" is the kind of line that rule was written for, and it doesn't help that Google wrote it rather than you. Other states' rules differ; check yours with your state board or counsel. (This isn't legal advice.)
Before launch, audit what Google will read:
- Page titles on the homepage and every landing page (the text in the browser tab and in search results).
- Meta descriptions, the short summaries under each page in Google's results.
- The first lines of each landing page, especially hero banners.
Replace superlatives with facts a patient can check: years in practice, services offered, plans accepted, doctors' names with the right designation.
AI Max Belongs at the End of the Rollout, Not the Start
Fixing the page is half the job. The other half is turning the feature off in the campaign. For the Isolation campaign, the exact-match campaign that holds your proven searches (our name at BrandRocket for it, from Chapter 6), switch AI Max off when you create it, which also turns off its text writing.
That's not a verdict on AI Max forever. It's a question of order. AI Max broadens where your ads can show and what they say, which works against a campaign whose whole purpose is tight control and clean data. In our rollout, AI Max comes at the very end, never inside an exact-match campaign, and only once you've written the text rules that keep it honest. Chapter 13 covers turning it on the right way.
AI Max Can Also Change Which Page the Patient Lands On
Text isn't the only thing AI Max changes. Its sibling setting, final URL expansion, can send a searcher to a different page of your site than the one you picked. Google's help center says that when text customization and final URL expansion are both on, it "may replace your Final URL with a more relevant landing page" and write a matching headline and description to go with it. Turning off text customization turns off final URL expansion too.
For an optometry website, that matters. The page Google judges most relevant to "eye exam near me" might be your online contact lens store, a blog post about dry eye or an old promotion page. A patient who clicked an exam ad and lands on a reorder login isn't going to book. Chapter 13 covers the URL exclusions that make these features safer if you turn them on later.
An Eye Exam Needs Someone Who Can Walk In
Location targeting is the next default to change. Google's standard option, "Presence or interest," shows your ads to people in your area and also to people elsewhere who've shown interest in it. Google recommends that broader option for businesses like travel, real estate and education, where interest in a place is the point.
An eye exam isn't a trip. The patient has to come to your office, usually more than once. Pick "Presence" so the ads reach people who live, work or spend time near the office, and draw the radius from how far your patients really drive. Your appointment records will tell you: look at where last year's new patients live.
Search Partners and Display Muddy Your First Months of Data
A new Search campaign is also set by default to show on Google's search partners and, depending on setup, on the Display Network. Turn both off at launch.
Our reasoning is about clean data. In the first months, every conversion teaches the account what a new patient looks like (Chapter 1). Search partner sites and display placements bring traffic with different behavior, and some of it isn't worth what it costs. Keep the early data coming from Google Search itself. Once the account has a steady base of bookings, you can test search partners separately and judge them on their own numbers.
An Ad That Runs While the Phones Are Off Wastes the Click
The ad schedule should match when a patient can actually act. If your ads drive phone calls, run them when the phones are answered, and allow a little lead time before opening. If your online scheduler takes bookings at any hour and the confirmation works, ads can run overnight for online booking, but they shouldn't promise a callback that won't come until tomorrow afternoon.
Speed promises need the same care. Chapter 6 covered "same day" and "walk in" searches. If your ads promise same-day exams, the schedule should switch those ads off on days and hours you can't keep the promise.
Eight Small Settings Cause Most of the Expensive Mistakes
A handful of smaller settings complete the build. None are dramatic, and all of them matter:
- Languages: match the languages your patients search in. If your team serves patients in Spanish, add Spanish, and make sure the landing page supports it.
- Budget: start below your target from Chapter 3 while bids settle (Chapter 7), then raise it.
- Dynamic Search Ads: off. They write ads from your site, too, with the same risks as text customization.
- Ad rotation: let Google favor the best-performing ads.
- Auto-tagging and call reporting: on, so clicks and calls connect to bookings (Chapter 1).
- Brand terms: in their own campaign, not mixed with exam searches.
- Campaign objective: pick one if Google asks. It shapes the setup screens, not how your ads are delivered.
- Age targeting: leave it open. The American Optometric Association recommends eye exams from infancy through every adult age, and parents searching for their children are among your best patients.
Write these down as a build sheet and check it against every new campaign. The expensive mistakes in Google Ads are rarely clever; they're a default nobody changed.
Recheck the Settings After Google's Next Update
Settings don't stay set. Google renamed and moved text customization in 2025, and defaults on new campaigns change from time to time. A campaign built correctly last year can pick up a new feature the next time someone edits it, or when a new campaign is copied from an old one.
Two habits keep this from becoming a surprise. First, review every campaign's settings each quarter against your build sheet, and after any Google announcement that mentions AI Max or Search campaigns. Second, check whether Google Ads is set to apply its recommendations automatically. Some recommendations are useful; applying them without review can switch on broad match, raise budgets or add assets you never read. We keep automatic application off and read each recommendation before deciding.
Next: Performance Max and the Chains' Audiences
With the Search campaigns set up correctly, the next step, months later, is Performance Max. It reaches across YouTube, Gmail, Maps and more, and it works best when you point it at the right people. Chapter 10 covers building its audiences from the websites of the optical chains your patients already browse.
Every chapter is listed on the guide's home page.
Before an eye care campaign we manage goes live under our Google Ads management, someone checks it line by line against this sheet, page titles included. Setting up your own? Read your homepage's page title and meta description today; they may already be writing your ads.
