Frequently Asked Questions

Ontario Health Insurance Plan (OHIP) covers eye care services for people 65 years and older and those younger than 20, for a routine eye examination provided by either an optometrist or physician once every 12 months plus any follow-up assessments that may be required. Specified ophthalmology services for patients of any age with specified medical conditions or diseases affecting the eyes are also insured.

Insured persons aged 20 to 64 years with specified medical conditions affecting the eye can receive an OHIP insured regular eye examination once every 12 months. Insured persons aged 20 to 64 with any of the following conditions can go directly to their optometrist or physician to receive an OHIP insured eye examination:

• diabetes mellitus
• glaucoma
• cataract
• retinal disease
• amblyopia
• visual field defects
• corneal disease
• strabismus
• recurrent uveitis
• optic pathway disease

Insured persons aged 20 to 64 who have certain medical conditions not listed above may also be covered for regular eye examinations. They should discuss this with their primary health care provider.

Ontario Health Insurance Plan (OHIP) eye care services NOT covered include routine eye examinations provided by either an optometrist or physician, for patients aged 20 to 64. These individuals are responsible for payment for these examinations or to arrange to have the cost covered by private insurance.

Under the Ministry of Community and Social Services (MCSS), persons receiving assistance through the Ontario Disability Support Program, Ontario Works, or the Family Benefits Program will receive coverage for routine eye examinations once every two years. If you have any questions about the coverage provided under these programs, please call Client Services at MCSS at 1-888-789-4199 (toll free) or 416-325-5666 (Toronto) or 1-800-387-5559 (TTY).

This information can also be found at http://www.health.gov.on.ca/en/public/publications/ohip/eyecare.aspx

When the Ministry of Transportation requires you to have your eyes tested there is a fee NOT covered by OHIP. For adults 80 years and over, renewing your G driver’s licence will be mandatory every 2 years.

More information can be found at http://www.ontario.ca/driving-and-roads/renew-g-drivers-licence-80-years-and-over

That “air-puff thing”, although mildly unpleasant, is an important test called non-contact tonometry (NCT). It provides a measurement of the internal fluid pressure of the eye. The doctor uses that information, along with other examination procedures to determine if you have glaucoma or have a risk of developing glaucoma.

Eye drops that dilate the pupils, called mydriatics, are used in some examinations to enable the doctor to get a better view of the inside of the eye. How often this type of examination is necessary depends on the patient’s symptoms, age, health and family history. The drops generally leave your eyes a little blurry and sensitive to light, so you may not be able to drive immediately after this procedure. The effect of the drops wears off in 2 to 6 hours.

Eye drops that relax the focus of the eyes, called cycloplegics are used to accurately measure the degree of far-sightedness of the eyes. These are generally used for children and young adults. These drops also leave the eyes blurry and sensitive to light.

Eye drops to anesthetize (numb) the eye are used for procedures that require an instrument touching the eye. The anesthetic does not affect vision and lasts about 15 minutes. Some eye drops contain a dye that helps the doctor diagnose abnormalities of the surface of the eye.