Patients worry as provincially-insured eyecare in Ontario remains on hold

Ontario optometrists continue to withhold all services covered by OHIP as they push the government to increase payment after claims of underfunding.

In March, 96 per cent of optometrists in the province voted to withdraw OHIP services, according to a statement posted on the website for the Ontario Association of Optometrists(OAO). Services were officially withdrawn on Sept. 1.

OHIP covered eye exams for people 19 years of age and younger, and for those 65 and older, as well as those who have special conditions, such as diabetes, glaucoma, and macular degeneration.

OHIP covered 55 per cent of eye exams, leaving optometrist clinics to cover the remainder. Service withdrawal will remain in place until the government and the OAO come to an agreement. Until then, eye exams are only available at a cost of $80 per customer.

Farhia Ahmed is over 65 and was covered for eye exams by OHIP. She also has Type 2 diabetes, which can directly impact the eyes and is a condition that is also covered by OHIP. She has an upcoming appointment at the end of October, and wonders if she can afford it.

“High blood sugar levels were affecting my eyes and my doctor was concerned so he referred me to an eye doctor because he thinks I need glasses for the night,” she says.

Ahmed is concerned that if her blood sugar levels do not come down, her eyesight will only get worse.

“I just don’t want to go blind because I was not treated when I should, it might sound extreme but diabetes — they attack your eyes, and I need my eyes. They are all I got,” she says.

More than four million optometrist services were delivered through OHIP annually.

The OAO says that was causing financial strain to clinics because optometrists were covering 45 per cent of costs out of pocket, making the system no longer sustainable. OAO withdrew OHIP-covered services once negotiations with the government stalled.

According to OAO, Minister of Health Christine Elliott announced a one-time payment of $39 million directly to optometrists in August 2021. The OAO says that’s not nearly enough to make providing services sustainable for optometrists.

Medical professionals in Ontario regularly negotiate their fees with the government but optometrists do not have that luxury of routine negotiations because it isn’t included in their regulations.

Listen to clips from Skedline’s interview with Farhia Ahmed