Who should see an Optometrist and how often?

Routine eye examinations are suggested for everyone regardless of how well they see. An eye examination involves testing of visual health as well as vision and function of your eyes. Routine examinations may also reveal undiagnosed health conditions such as cancer, diabetes and high blood pressure to name a few. Depending on the findings yearly or every two years may be recommended for follow up examinations. Regardless of age, health, or vision a full examination is recommended every two years.

When did OHIP stop covering eye exams?

Routine eye examinations for people 20 to 64 years old were no longer covered as of November 1, 2004. There is new OHIP coverage to ensure patients aged 20 to 64 years with medical conditions affecting the eye can continue to receive regular eye examinations.

Are persons between 20 and 64 exempt from paying for eye examinations if they have certain specific medical conditions?

Patients aged 20 to 64 years who have any of the following medical conditions can go directly to their optometrist to receive an eye examination once every 12 months : diabetes mellitus, glaucoma, cataract, retinal disease, amblyopia, visual field defects, corneal disease, and strabismus. Prior to November 1, 2004, eye examinations were covered once every two years.

When should I bring in my child for an eye exam?

Thankfully children in Ontario are still covered yearly for eye exams. It is suggested to have an eye examination at 6 months of age and then again at 3 years old followed up annually. If you haven’t done so yet please book your child right away. Many eye conditions are easily treated if caught early and can quickly become permanent if left undiagnosed. Vision and learning are strongly connected and often children struggle with school as a result of vision problems their parents are unaware of.

How to you test young children’s eyes?

We have several tests specifically designed to make the eye examination fun while allowing us to gather the proper information about their vision. Even if you have a shy child we can play a movie and test the child as they watch a short video clip, no interaction is needed to gather critical information.

I am 71 and have glaucoma. Does OHIP still cover my eye examinations?

Yes. OHIP coverage for seniors has not been changed.

Do persons aged 20 to 64 with medical conditions affecting the eye need to get a physician referral in order to see their optometrist now?

Patients aged 20 to 64 who have conditions not listed above may also be covered for a regular eye examination. Patients should discuss this with their primary health care provider. A requisition will be provided when appropriate for an OHIP covered eye examination.

I am 52 and have diabetes. How often will OHIP pay for me to see my eye care physician or optometrist?

OHIP pays for you to have one eye examination every 12 months. OHIP also covers any follow-up care you require before you have your next major eye examination. Prior to November 1, 2004, OHIP covered eye examinations once every two years.

Are eye care services covered for people receiving social assistance?

The Ministry of Community and Social Services has established a program to ensure people receiving social assistance are covered for regular eye examinations as they have been in the past. Persons in receipt of assistance under the Ontario Disability Support Program, Ontario Works or the Family Benefits Program will receive coverage for regular eye examinations. Coverage is once every two years.

If you have any questions, please call Client Services at the Ministry of Community and Social Services at 1 (888) 789-4199 (toll free) or (416) 325-5666 (Toronto) or 1 (800) 387-5559 (TTY).

How much will routine optometry eye examinations cost for people who are not covered by OHIP? Will the cost be regulated?

The optometrist determines patient fees in accordance with their associations guidelines. The ministry does not play a role in regulating these fees.