<p><strong>Background:</strong> Effective communication is a core component of quality healthcare, influencing patient satisfaction, treatment adherence and health outcomes. The global shift toward patient-centred care, health equity and interprofessional collaboration has further elevated communication as a critical skill. However, in optometry education, formal structured communication training remains limited.<br /><strong>Aim:</strong> This narrative review synthesis the existing literature to support the development of an evidence-based, standardised framework that promotes communication competence among undergraduate optometry students across diverse clinical contexts.<br /><strong>Method:</strong> A comprehensive search was conducted across multiple databases, including MEDLINE, Academic Search Ultimate, CINAHL with Full Text and Scopus. A keyword-based search strategy employed Boolean operators and truncation (e.g., communicat*, undergrad*, optom*, train*) to capture variations in terminology across disciplines. The search covered the period from 1 January 2014 to 31 December 2024.<br /><strong>Results:</strong> In total, 1053 records were retrieved and 412 duplicates removed. The remaining 641 titles and abstracts were screened, with 30 studies meeting the full-text inclusion criteria.<br /><strong>Conclusion:</strong> The review highlights that structured communication skills training, particularly when supported by feedback, simulation interactions and reflective learning, can enhance clinical preparedness and professional confidence. However, the effectiveness of these interventions is influenced by factors such as student characteristics, resources and learning objectives.<br /><strong>Contribution:</strong> Although several strategies show promise, there remains a need for longitudinal research to assess the long-term effects of communication skills training interventions. Establishing a structured, context-sensitive framework is essential to address current gaps and support optometry students in developing the communication skills required for effective, patient-centred practice.</p>