The legislative and policy-making body of the New York State Optometric Association is the House of Delegates, which is established and functions as provided in the bylaws. The administrative body of this association is the Board of Trustees, which implements the policies established by the House of Delegates and performs such duties as are prescribed in the bylaws.

The Board of Trustees consists of six elected Officers and seven Regional Trustees.

Officers serve one-year terms and are elected at the Annual Meeting in a two-part vote of individual members (the Membership vote) and the Association's affiliated local societies (the Society vote).

Regional trustees serve three-year terms and are elected by the members of the local societies within their respective region. The state's three Regions - Finger Lakes-Niagara, Hudson-Mohawk, and Metropolitan - each encompass 4-5 local societies.