Getting Eye Care

Ophthalmologists, or eye physicians and surgeons, are specialists who manage patients with eye disease. You require a referral from a primary care provider (optometrist, family doctor, nurse practitioner, emergency room physician) to see an ophthalmologist.

Ophthalmologists are trained to diagnose and treat patients with all levels of eye disease.  Patients can be managed medically (drops, medications) or with procedures. Ophthalmologists perform lasers and intraocular (inside the eye) and extraocular (around the eye) surgeries.  Many ophthalmologists will have a subspecialty interest such as retina, glaucoma, cornea, paediatrics, oculoplastics and others.

Ophthalmologists go to medical school for 4 years after completing a 4 year undergraduate degree and sometimes also a postgraduate degree (Masters or PhD).  Once they complete medical school they begin a 5 year postgraduate ophthalmology residency training program in the management of eye diseases and eye surgery. Several ophthalmologists will then pursue fellowship training in subspecialties that require 1 to 2 more years of training.

Ophthalmologists, like other medical doctors and surgeons, are regulated healthcare professionals governed provincially by the College of Physicians and Surgeons of Ontario. OHIP covers all medically necessary visits, tests and procedures (lasers and surgeries) performed by an ophthalmologist.  Ophthalmologists are on staff at local hospitals and provide call coverage 24/7 for patients.

An optometrist is a primary eye care provider and many people in the Waterloo Region will have a “family optometrist” much like they have a family doctor.  You can schedule an appointment with an optometrist without a referral.

Optometrists see healthy patients, prescribe glasses and contact lenses, screen for eye disease in those at risk, diagnose and treat many eye diseases but will refer to an ophthalmologist if more advanced care and surgery is required.

Optometrists complete a 4-year Doctor of Optometry degree that requires 3 years of prior university study.  Many optometrists in the Waterloo Region will have trained locally at the University of Waterloo School of Optometry and Vision Sciences. Qualified optometrists may then do a year of postgraduate training in an area of interest such as vision rehabilitation, cornea and contact lenses, pediatric optometry, ocular diseases and others.

Optometry is a regulated healthcare profession and governed provincially by the College of Optometrists of Ontario. The Ontario health insurance plan (OHIP) covers yearly patient optometry exams for those under 20 or over 65 years of age.  OHIP also covers yearly optometrist exams for patients with certain eye diseases at any age. Patients not covered by OHIP may be covered by their private health insurance plans for optometrist visits.

Babies get a rudimentary eye assessment by their family doctor/nurse practitioner as part of the well-baby visit. The Ontario Association of Optometrists recommends that all babies have their first optometrist exam at 6 months, then if all is normal again at 3 years of age and then yearly. A pediatric eye exam involves taking vision, measuring the alignment and binocularity, measuring for glasses, and doing a thorough assessment of eye health with dilating eye drops. Children should get comprehensive eye examinations to look for common childhood conditions such as strabismus (eye crossing), amblyopia (lazy eye), and refractive error (need for glasses). Link: Pediatric Optometrist Exam

Healthy adults should get comprehensive eye exams every couple of years with their family optometrist. OHIP does not cover eye examinations in healthy patients between the ages of 20 and 64 but private insurance plans often do. Glaucoma-related visits to the optometrist are always covered by OHIP, at any age, as often as needed to manage the disease throughout life.

Patients with medical diseases or patients taking medications should ask their family doctor, nurse practitioner, specialist, or optometrist if they require more frequent eye examinations.  Patients with diabetes require yearly screening eye examinations with their optometrist and this is covered by OHIP.

Patients who develop visual symptoms should get an eye examination with their optometrist.  Your family doctor can request a medical eye exam for you and OHIP will cover the cost of the optometrist assessment. Link: Major Eye Exam OHIP Request Form.

OHIP covers yearly comprehensive eye examinations with an optometrist in all adults over 65.  This is because the risk of age-related eye diseases —cataract, glaucoma, macular degeneration—increases over time.  Identifying eye disease early will often reduce disease progression and preserve vision.