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Cost of Eye Exam in Ontario vs. OHIP Eye Exam Coverage

A young girl is covering her right eye during a visual acuity test.

As many have heard, there will be changes to OHIP coverage for eye care services starting on September 1, 2023. As optometrists, our top priority is to keep high-quality eye care accessible and help prepare you for these upcoming changes so that you can plan accordingly. We can inform you of the changes, who they will affect, and what steps you can take to continue receiving the care you need.

The costs of comprehensive eye exams are as follows:

  • $150 for all non-OHIP insured patients. All exams include OCT and Retinal Photography.

 The New OHIP Changes in 2023:

With the new OHIP changes, patients from 20 to 64 years of age will have an OHIP-covered comprehensive eye exam every 12 months if they have one or more of the following conditions:

  • Glaucoma requiring or having had treatment with medication, laser (excluding prophylactic laser peripheral iridotomy;
  • Diabetes;
  • Retinal disease that is acute, or is chronically progressive;
  • Corneal disease that is acute, or is chronically progressive;
  • Cataracts that significantly impact visual acuity;
  • Uveitis that is acute or chronic during episodes of active inflammation;
  • Optic pathway disease that is acute, or is chronically progressive;
  • Acquired cranial nerve palsy resulting in strabismus during the acute phase or until the condition resolves or stabilizes;
  • Ocular drug toxicity screening for patients taking hydroxychloroquine, chloroquine, ethambutol or tamoxifen;

For seniors 65 and over without medical or eye conditions, eye exams will be covered by OHIP every 18 months. 

Two minor follow up assessments are permitted between the major eye examination period.

Cost of Eye Exams in Ontario

Comprehensive Eye Exams

Regular eye exams are a key component of healthy eyes and vision. All eye exams include standard tests, such as:

  • Visual acuity
  • Preliminary tests, including depth perception and colour vision
  • Refraction error test
  • Eye focusing, eye teaming, and eye movement
  • Eye health evaluation
  • Supplementary tests

All comprehensive eye exams with One Vision Eyecare include optical coherence tomography and retinal photography. Optical coherence tomography (OCT) is a retinal imaging test that provides cross-sectional views of the layers of the eye structures near the back of the eye, including the macula and optic nerve.

Retinal imaging is a powerful diagnostic tool used to detect a range of eye conditions, including:

Visual Field Assessment

A visual field test is an additional part of your comprehensive eye exam if deemed necessary. Patients with eligible medical conditions are insured under OHIP. By evaluating your entire field of vision—above, below, and to both sides of your eyes—your optometrist can identify any defects in your vision, including: 

  • Congruity problems in both eyes, typically a problem affecting the brain
  • Visual field loss in one eye or damage to the optic nerve
  • Visual field loss in both eyes, typically caused by an eye condition

There are several reasons why your optometrist may recommend a visual field test, including evaluating baseline and comparison results to monitor eye conditions such as glaucoma. A visual field assessment is $65 with a comprehensive eye exam.

Contact Lens Exam & Fitting

Contact lenses can be a versatile option for those who want an alternative to glasses. To find comfortable and clear contact lenses for your eyes, your optometrist must take various measurements of your eyes to get the perfect fit, including:

  • Curvature of the cornea
  • Pupil measurement
  • Iris measurement

Poorly fitting contact lenses can lead to low moisture and hypoxia, contributing to complications such as infection, corneal ulcers, lens intolerance, or dry eye.

A comprehensive eye exam with a contact lens assessment is $200.

Dry Eye Diagnosis & Treatment

Problems with tear production are a common issue that causes the gritty, burning, and stinging discomfort of dry eye. In most cases, dry eyes occur when the tears evaporate too quickly, leaving the ocular surface irritated and inflamed. The most common cause of dry eye is meibomian gland dysfunction, which occurs when the oil-producing glands are blocked and can’t form healthy tears.

A comprehensive eye exam with a dry eye evaluation using the Ocular Surface Analyzer is $200. We take photos of the meibomian glands to visually evaluate the blockages or damage and examine the ocular surface health.

Once you have a diagnosis, we can provide a range of treatments from nutrition and lifestyle advice to Eye-Light intense pulsed light (IPL) therapy and low-level light therapy (LLLT).

This treatment uses short bursts of light to the skin around the eye to reduce inflammation and warm the meibomian glands and melt the hardening oil buildup. It’s then easier to express the glands and promote healthy tear production.

IPL and LLLT Therapy is $350 per treatment, or with the package bundle, it’s $1050 for 4 treatments (regular price $1400).

A young boy tests his vision through a lens tool at his eye doctor's office

How to Manage the OHIP Changes as a Patient

So, what options are available for patients not covered under OHIP for their comprehensive eye exams? First and foremost, private insurance plans may cover the cost of eye exams and other services such as prescription eyeglasses or contact lenses.

It’s important to review your current health insurance plan to determine what coverage is available to you.

Another option to consider is the potential benefits of early intervention in the case of eye disease. Waiting for symptoms to develop and advance before seeking treatment can often result in more severe conditions and higher treatment costs.

If you’re not eligible for OHIP coverage for eye exams, you may benefit from more frequent exams to detect potential issues early on. Optometrists can work with you to tailor a preventive care plan that suits your individual needs and employment or private insurance coverage.

Preventative Eye Care in Ontario

We recommend staying informed and up-to-date with any developments affecting your access to eye care services. The optometry team at One Vision Eyecare is here to help guide you through these changes and provide support in any way possible. Contact us or book an appointment online if you have questions about your coverage and to schedule your next eye exam.

Written by Dr. Jay Gill

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