Starting April 1st, 2023, there are changes that have been made to eligibility for eye exams under OHIP. Please take the time to review this new information.
Who is covered?
Children younger than 20 are covered for a routine eye examination provided by an optometrist once every 12 months plus any follow-up assessments that may be required.
Adults aged 20 to 64 with any of the following medical or ocular conditions are eligible for a routine eye exam once every 12 months plus up to 2 additional follow-up assessments that may be required: Diabetes Mellitus, Glaucoma, Retinal Disease, Corneal Disease, Optic Pathway Disease, and Cataracts requiring surgical referral or causing a significant decrease in vision.
- In addition, coverage has been expanded for people taking certain medications that have the potential to cause ocular side effects including Chloroquine, Hydroxychloroquine, Tamoxifen, and Ethambutol.
Seniors aged 65 and older are covered for a routine eye examination provided by an optometrist once every 18 months plus up to 2 additional follow-up assessments that may be required. Seniors with any of the following medical or ocular conditions will remain eligible for eye exams once every 12 months plus up to 2 additional follow-up assessments that may be required: Diabetes Mellitus, Glaucoma, Retinal Disease, Corneal Disease, Optic Pathway Disease, and Cataracts requiring surgical referral or causing a significant decrease in vision.
- In addition, coverage has been expanded to include coverage for seniors taking certain medications that have the potential to cause ocular side effects including Chloroquine, Hydroxychloroquine, Tamoxifen, and Ethambutol.
Why is the eligibility criteria changing?
The Ontario Association of Optometrists and the Ministry of Health have reached a consensus regarding the appropriate amount of OHIP coverage based on the best clinical evidence.
This deal is modernizing how eye care is delivered in Ontario, bringing us in line with other provinces, and these changes will allow optometrists to prioritize seniors with the highest needs.
All decisions made on modernizing eye care delivery in Ontario were based on jurisdictional evidence and the desire to ensure Ontarians most vulnerable to vision-loss can access the care they need.
What will my exam cost if I am not covered?
Please review the table below for our fees for services. There may be additional fees if your optometrist recommends specialized testing, you are seeking a contact lens fitting, or if you require an exam report or summary at the completion of your visit.
| Exam Type | Fee | |
| Comprehensive Exam | Includes retinal photography | $155 |
| Minor Exam | Varies by complexity | $35-80 |
We look forward to seeing you soon at Almonte Family Optometrists and Gloucester Family Optometrists. Please reach out if you have questions.