Based on the existing practical teaching curriculum system, optometry skill competition items were designed to align closely with the teaching content, and professional skill competitions were introduced in the latter half of the teaching process. These items were deeply integrated into daily teaching links to construct a practical competition-based courses, aiming to explore the actual effect of this teaching mode on improving students' practical skills. Third-year undergraduate students majoring in optometry were selected. Using classes as units, the method of cluster random sampling was adopted, and the selected students were randomly divided into a control group and a curriculum reform group. The curriculum reform group implemented the practical competition-based course, while the control group implemented the traditional practical course. Both groups had the same total hours of practical teaching and participated uniformly in the optometry skill competition and assessment scoring. The teaching results showed that the scores of the curriculum reform group in single-item skill assessments such as retinoscopy, visual function examination, contact lens fitting, and synoptophore examination, as well as the average score, were significantly higher than those of the control group (P<0.01). Thus, this study indicated that the competition-based practical teaching mode could improve students' practical skills and might meet the needs of optometry talent training under the new situation.