The stand-off between Ontario’s optometrists and the provincial government continues with no end in sight. Since September 1, nearly 95% of the province’s 2,500 optometrists have stopped performing OHIP-funded services for people under the age of 20, seniors aged 65 and over and individuals on disability.

Earlier this month, the Ontario government offered a one-time payment of $39 million to indicate a “starting point” in support of optometrists and to further discussions along. A spokesperson from the Ministry of Health (MOH) told the Corriere that, “payments will flow to optometrists across Ontario on October 15”.

“In addition to this one-time funding boost, our government has also offered to increase OHIP fee reimbursements to optometrists by 8.48%, retroactive to April 1, 2021”, she added. The MOH also proposed to immediately set up a joint working group to collaborate on investigating the cost of overhead.

In response to the one-time payment, Dr. Sheldon Salaba, President of the Ontario Association of Optometrists (OAO), told the Corriere, “this one-time payment from the government covers less than one quarter of the funding deficit to reach our cost to perform OHIP services in a single year”.

“As of today [October 15], over 2,100 optometrists have written Minister Elliott urging her to keep this money and commit to working out a deal where we will no longer receive the lowest compensation for an eye exam in all of Canada”.

The dispute stems from more than thirty years of chronic underfunding by the Ontario government. Currently, the province covers an average of 55% of the cost for an OHIP-insured eye exam. The OAO explained that the remaining 45% must be shouldered by the provider and with the surge in operating costs, the system is no longer sustainable.

According to the MOH, “the current impasse lays squarely at the feet of the OAO”. They argue that “instead of participating in good-faith negotiations, [the OAO] is choosing to demand an outcome before allowing them [the negotiations] to start”.

Dr. Salaba maintains that “the OAO can confirm that we remain firmly seated at the bargaining table”. While he could not provide details of the bargaining process as it remains largely confidential, he said, “the conditions provided by the mediator did not capture any long-term solutions”. As the stalemate continues, the full extent of the impact for OHIP-insured patients affected by the job action remains unknown.

However, the lack of resolution compounds a growing eye care emergency in the wake of Covid-19. An addendum to the summary report, The Cost of Vision Loss and Blindness in Canada: The impact of Covid-19 (September 2021) by the Canadian Council of the Blind estimated nearly three million Canadians skipped optometry services in 2020, as compared to 2019. For those living with major eye conditions like cataract, glaucoma and age-related macular degeneration (AMD), delays in eye care may have serious and ongoing implications for years to come. The Report suggests an estimated 1,437 Canadians lost vision due to delayed eye exams and treatments in 2020.

Furthermore, the Report estimated it would take roughly two years to clear the backlog of cataract surgeries alone. The cost to clear such a backlog is pegged at an additional $129 million per year.

“As doctors, it is our number one priority to advocate and defend our patients’ right to quality healthcare”, Dr. Salaba said. He maintains that the MOH’s one-time payment “does not commit to any long-term solution or mechanism to address this crisis in eye care”. For now, Canadians are left in the dark without any indication on when a possible resolution will be achieved.

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