Eye care in Ontario is at risk.

Without immediate attention, we may lose this essential
health care service.

Let’s open our eyes and save eye care together.

Ontario’s optometrists take pride in being highly accessible health professionals, but they are struggling.

Today’s crisis is worse because successive governments have failed to invest in eye care for 30 years. OHIP doesn’t cover even half the cost of an eye exam, let alone the tests that help optometrists diagnose patients safely and accurately. It’s only fair to cover the costs and improve front line eye care.

Here’s why we are standing up for our patients and fighting for access to care:

Without a funding solution, the future of eye care in Ontario is at risk, particularly in smaller communities.
70 per cent of patients are OHIP-insured, many with serious eye care needs. And the population is aging. If we can’t take care of them, who will?
Optometrists don’t have a process to negotiate with government – the way other health professions do. Without this, the front line of eye care is at risk for many Ontarians.

The Ontario government can fix this. Tell Premier Ford that patients like you deserve continued access to the high-quality eye care provided by optometrists.

Take action.

Open letter to the Government of Ontario

Dear Premier, Deputy Premier and Minister of Health, and MPPs

I am writing because access to eye care is important to me, my family, and my community – and it is in crisis in Ontario today. You can help prevent this crisis from getting worse.

For 30 years, previous governments neglected to invest in eye care. It is wrong that OHIP only covers half the cost of an eye exam, and that optometrists have to subsidize the rest. Now, social distancing means my optometrist can only see half the patients as before. Staying in business will be hard.

I fear what this means for my eye health – and that of my family. Without immediate attention from your government, we risk losing an essential front-line health care service in Ontario communities. And the practices that employ thousands of people across the province.

The last thing we need is more Ontarians, like me, having to wait in the ER for a service we can and should receive in our community.

Please return to the discussion table with Ontario’s optometrists. You can lead where previous governments failed — and save eye care in Ontario.

Help save eye care in Ontario.

By submitting a letter to the Ontario Premier, Minister of Health, and your local MPP, you will open the government’s eyes to this crisis – and help protect eye care in your community.

Your questions, answered.

If patients are covered by OHIP, private insurance or are paying out-of-pocket, how are optometrists losing money in seeing patients?

OHIP covers eye care for children up to age 19, seniors over 65 and Ontarians with certain health concerns. To deliver a comprehensive eye exam in Ontario, it costs optometrists upwards of $80 (staff pay, equipment, and other overhead costs). OHIP only pays $47 for each covered eye exam, leaving your optometrist to make up the difference. As Ontario’s population ages, about 70% of our patients are covered by OHIP and this number continues to grow. We’re currently subsidizing the eye care system by $173 million every year and as you can appreciate, operating at a loss for the majority of our patients is not sustainable.

The whole healthcare system is in trouble. What makes optometrists any different?

Ontario’s optometrists have struggled as both health professionals and small businesses. 95% have seen their revenue drop between 75%-80%. COVID-19 has ignited the crisis – but it’s fueled by 30 years of failure to invest in eye care. This is a growing crisis that will continue to affect patient care if a commitment is not made soon. Our biggest concern is how this crisis will affect patient care, because it’s putting stress on our ERs at the worst possible time. That’s why need the government to work with us -- to ensure Ontarians get the accessible, quality eye care they deserve.

Why is there a gap in funding for OHIP patients?

Unfortunately, the Ontario government has made only minimal investments in optometric services since 1989; for more than 30 years, this has not even been enough to keep up with inflation. As a result, OHIP now only covers half the cost of an eye exam. We pay the rest out of our own pockets and it costs us over $173 million every year. This government has a difficult job to do during this crisis – but with eye care, they have an opportunity to take action where previous governments have failed.

Is the problem then just that optometrists want to charge a higher fee for eye exams?

To deliver a comprehensive eye exam in Ontario, it costs optometrists upwards of $80, but OHIP only pays $47 for each covered eye exam, leaving optometrists to make up the difference. The cost is significant — $173 million a year. The system is not sustainable, and it threatens access to patient care. We’re asking this government to succeed where other governments have failed to either cover the true cost of eye exams or give optometrists more flexibility in our billings. Operating at a loss is not sustainable.

Does Save Eye Care mean we’re losing eye coverage from OHIP entirely?

Eye care in Ontario is in crisis – after 30 years of chronic underfunding (plus the crippling effects of the pandemic) optometrists are struggling to keep their doors open. OHIP only covers about half the cost of a comprehensive eye exam, leaving optometrists to pay the difference out of their own pockets. This is costing us more than $173 million every year. We can’t do it anymore. We’re asking the government to come to a solution with us that allows Ontarians to maintain their eye care support through OHIP, while allowing us to reach a sustainable solution. With proper funding from government, we can build a solution that works over the long term and protects crucial access to eye care for all covered Ontarians.

Patients deserve the best care possible.

Dr. Genevieve Raby,
Alexandria, Raby & Associates, Optometrists

Due to COVID restrictions, our staff is working split shifts. When I arrived to work one Monday afternoon, a staff member informed me that a long-term patient called to ask me to see his 101 year-old aunt, who is also a patient. She had been seeing a large black spot in front of her left eye for a few days.

He was directed by our staff to go to the nearest hospital where there is an ophthalmologist on call. We are in a rural area and do not have an ophthalmology department in our local hospital. He was upset as his aunt lives in a nursing home and they preferred she did not go to the hospital. Also, he did not feel that the patient was well enough to travel to this hospital and wait to be seen for an undetermined amount of time. He clearly stated that he would not take her to the hospital. Her physician was also away for the next three days. I made the decision to see this patient knowing that her primary care physician would not be able to examine, diagnose and treat for this type of symptom.

She was not feeling well on Tuesday, but she came to her appointment anyway. She said to me that her vision was important to her. “I don’t want to go blind”. Keeping the mask on throughout her examination was difficult for her. Even, walking down the hallway to my exam chair was difficult for her. It made me wonder how she could have dealt with a hospital ER.

At her previous yearly examination in 2019, this patient’s vision was excellent but was now diagnosed with a large choroidal neovascular membrane caused by wet macular degeneration. I contacted our local ophthalmologist and made arrangements for her to be seen for treatment. I explained the difficult situation with her fragile health, and they assured me that they would do their best to avoid any wait time in their office.

I can’t help but think back to the response that we got from the government during COVID that optometrists were not essential first line healthcare professionals. I honestly do not believe that this extremely vulnerable lady would have been able to access care any other way. Her nephew made it clear to us that the other alternatives were not an option for them. This patient was seen immediately in our office when she arrived and her visit at the ophthalmologist’s will be efficiently managed because they already have a diagnosis and are aware of her general health status.

Situations like this one happen every week in our practice. This patient, as well as all the others just like her, deserve the best possible care. This involves getting diagnosed and treated effectively. And it also involves looking at the bigger picture and participating in helping our elderly population have a better quality of life.

Without change, Ontarians must accept this new normal.

Dr. John Parks,
Chatham-Kent, McCabe Parks Optometry

We’re seeing a huge decrease in the number of patients we’re seeing because of COVID. We’re spending more time cleaning the office but seeing fewer patients due to social distancing.

Normally, we could stay afloat if volume is high, even if renumeration is not great. However, when renumeration is not great and volume is significantly down you have to be very deliberate about the patients you’re seeing. We try to see everyone we can and see patients based on need, but now we have to limit the number of OHIP patients.

It’s been difficult for us to subsidize OHIP-insured patients for many years now and COVID-19 has made it much more difficult for us to continue to subsidize these patients. It will be difficult to see more patients in the future and difficult for us to survive if OHIP doesn’t increase funding so that we’re at least not losing money on these patients when we see them.

I’ve been doing this for 25 years and I want patients to get the best care possible. This is impossible with the current system and I don’t see it getting better any time soon. We cannot continue to subsidize exams out of pocket and risk losing our practice. If we can’t operate, how will that help Ontarians?

Without change, Ontarians will need to get used to this new normal.

If my practice is not sustainable, how will that help save eye care?

Dr. Karine Briand,
Timmins / Iroquois Falls, Family Eye Care

Currently, the biggest challenge we’re facing is booking patients in Ontario to receive eye care. With limited time slots and significant demand, we are trying to figure out how to care for patients, especially those who have an acute or urgent concern.

When patients call in, the problem we face is utilizing our limited appointment slots. I was having to subsidize OHIP care prior to COVID-19. Now we have increased overhead expenses, we are scheduling longer appointments to meet regulations and therefore have less appointment availabilities which means I am further subsidizing OHIP care. OHIP, especially OHIP partial exams don’t sustain the practice, period. I’m stuck in a place where I want to help my patients but don’t have the space – and if I have the space, I don’t know how I can possibly carry the cost. We’re extremely underfunded by OHIP remuneration. I have bills to pay, staff to employ and significant overhead, making it extremely difficult to care for OHIP covered patients.

It’s even harder to provide urgent care. Once we see a patient with an urgent need, we need access to ophthalmology care which is extremely difficult, especially in northern Ontario, where they’re also seeing fewer patients and having to redesign their practice. We’re trying to control intake of patients while sustaining a practice which results in patients being triaged and told to go to the hospital.

We just can’t afford to do emergency eye care right now.

I care for my patients, I want to take care of their eyes, but I also need to make sure that my business will survive. If my practice is not sustainable, those are jobs lost. How will that help save eye care?

It’s gone on for so long, it might be putting us out of business.

Dr. Susan Leet,
Pickering, Leet Meldrew Optometry

The impacts of COVID-19 alone will be devastating to my practice. As an older doctor seeing mostly OHIP patients, the new restrictions in the workplace means I can barely pay my share of the overhead. I can’t carry on without dramatically increasing my hours, which I’m not prepared to do. It’s pretty disastrous.

The way OHIP renumeration is set up was already dire. In my 35 years, I have gone through every negotiation with the Government and been an active voice for reform. I’ve had meetings, written letters and done everything I could possibly do only to find ourselves back to square one. All this work and absolutely nothing has changed.

Optometrists have never been properly compensated for the work we do. I find myself asking why am I doing this – there’s no way to earn an income of any kind. I, myself, will be left with no choice but to retire. For 35 years, I have always put my patients first. I care for my patients and their health. But it’s no longer a time to play nice. We can’t afford to continuously roll over and just do what’s best for patients – as much as we want to. It’s gone on for so long, it might be putting us out of business.

This will not help save eye care in Ontario.

I’m reaching a turning point. The stresses of reduced patient intake, high overhead and inadequate reform for optometrists is such that I can’t enjoy my job anymore. It’s become challenging for me moving forward to justify working. It’s just not feasible.

When will the government start to listen?

The time to save eye care in Ontario is now.

Dr. Jamie Maki,
Sudbury, Jamie Maki Optometry

Access to eye care in Ontario is in trouble. With the current state of the world, so much is unknown. Since re-opening, I’ve had to cut down my practice to 40% capacity. I’m realizing more every day that things are changing, and we simply will not be able to see the same number of patients in the given time frame.

How am I expected to pay my staff, pay rent, when we’re paying out of pocket to save eye care? I am one of the few in Ontario who has said that I’m done seeing OHIP patients – I cannot personally afford to any longer. I could barely do it before COVID and now there is just no way to do so and hope to run a business.

What many fail to understand is the financial situation the government has put us in. Even more jarring is how long it’s been since the government has done anything about it. I graduated in 1992 –I have been waiting 30 years for the government to make effective change.

I am fed up – it’s become too much.

Unfortunately, patients will soon feel the impact on access to eye care in Ontario if we don’t make changes now. Patients in Ontario will have nowhere to turn to, and some will have to go to emergency in a time where we cannot afford to so.

We simply cannot continue to see patients under the current OHIP guidelines and expect to make money. The time to save eye care in Ontario is now. We cannot afford to wait any longer.

We need early intervention to save eye care in Ontario.

Dr. Angela Peddle and Dr. Jeff Speers,
Etobicoke, Elite Vision Therapy Centre

In our practice, we primarily deal with pediatrics and vision rehabilitation, which means we see many patients with special needs and in an immunocompromised state.

We expect everything to change once we reopen. With our population of immunocompromised patients, there is no room for error. We need to ensure we have all the proper supplies and that the proper systems and protocols are in place to protect our patients and our staff. The current return-to-work plan will mean a drastically reduced patient load with increased expenses to ensure we are properly equipped.

We also worry about increased fear in the community. With extended waitlists and delays in seeing patients, we risk missing vital symptoms. The last thing we want is for people to wait until the last minute to see a doctor and for it to be too late. We need early intervention because when we don’t get to patients on time, we risk vision and we risk lives.

This will change the whole nature of our practice and those qualifying for our services. It is impossible to continue operating the way OHIP fees are set up. With the decreased number of pediatric patients we are able to see, and the impossibly low renumeration, we will be operating at a significant loss for each OHIP patient. This could force us to prioritize our private pay patients just to keep our doors open.

We care deeply for all of our patients. This is not what we want to implement, but it is what it will come to without immediate action and change.

Learn more.

"Optometrists are the front-line workers of the vision care system, and their services are at the heart of preventative screening for vision health in Ontario. With statistics showing that one in three Ontarians will encounter risk of vision loss by age 65, the government must work with optometrists to find a sustainable solution. The modernization plan includes properly supporting and expanding public coverage for routine eye exams; a crucial step in early detection of eye complications, avoiding irreversible vision loss."

Doug Earle

President and CEO, Fighting Blindness Canada

"With an aging population and increase in chronic sight-threatening disease, the need for optometrists will continue to grow. However, the recent spotlight on the poor economics of publicly funded eye care may pose a threat to access to care and the viability of the profession."

Dr. Stan Woo

Director, University of Waterloo School of Optometry and Vision Science