Changes to OHIP covered eye examinations as of September 1, 2023

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Dear patients of Polaris Eye Care,

As you may or may not know, there are some changes being made to OHIP eligibility for eye exams. Please find the information for your age group below.

Ages 19 and under:

OHIP coverage for eye examinations remains the same for this age group after September 1, 2023.

A patient aged 19 years and younger continues to be eligible for an OHIP-insured comprehensive eye examination once per year from an optometrist.

A patient aged 19 years and younger is also eligible for OHIP-insured “partial examinations” in between regular check-ups for a specific eye or vision problem.

OHIP does not cover second opinions. An examination by a different optometrist to confirm a diagnosis is not covered by OHIP.

Ages 20-64:

A patient aged 20 to 64 with one or more of the potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination by an optometrist (maximum once every 12 months).

A referral made by a physician to an optometrist is only insured by OHIP if one of the 9 conditions exists.

In addition, a patient with any of the 9 conditions is eligible for a maximum of two OHIP-insured follow-up “partial examinations” annually for that condition.

Strabismus and Amblyopia will no longer be considered eligible conditions for OHIP-insured eye examinations.

Ages 65 and up:

A patient aged 65 and over with one or more of the potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination once every 12 months from an optometrist.

A patient aged 65 and over without one of the 9 potentially sight-threatening conditions is eligible for an OHIP-insured comprehensive eye examination once every 18 months from an optometrist.

All patients aged 65 and over are eligible for a maximum of two OHIP-insured “partial examinations” in between regular check-ups if needed.

*Eligible conditions are as follows. Please visit www.OHIPupdates.ca for more information.

  • Diabetes

  • Glaucoma

  • Cataracts

  • Retinal disease

  • Corneal disease

  • Optic nerve pathway disease

  • Uveitis

  • Patients taking any of the following medications: Chloroquine, Hydroxychloroquine, Ethambutol, Tamoxifen.

  • Sudden onset of strabismus (eye turn/crossed-eyes) due to injury or disease

Please do not hesitate to contact our office should you have any questions or concerns regarding these changes.

Warm regards,

Polaris Eye Care