Vision Care and Eye Disease: Are You Covered?

Person looking at eye scan

On June 2, 2022, Dr. Andre Stanberry presented to the mostly advisor and insurer attendees at the latest vision care webinar from the Canadian Association of Optometrist. Dr. Stanberry is Clinic Director and Associate Clinical Professor of Optometry at University of Waterloo. In his presentation, Dr. Stanberry noted there are 1.2 million Canadians living with vision loss and 8 million living with an eye disease that may lead to blindness. The direct health system costs are $9.5 billion and productivity losses are $4.3 billion. According to the Director General of the World Health Organization, 80% of visual impairment is either preventable or curable with treatment.

Dr. Stanberry identified and reviewed the impact on vision of three serious eye diseases that have significant personal, economic and workplace costs. Attendees learned that while cataracts will affect most of us as we age, it is a reversable eye disease, treated with surgery. Glaucoma, age related macular degeneration (AMD), and diabetic retinopathy are not reversable.

Here are some facts:

  •  Glaucoma - approximately 730,000 Canadians have glaucoma and about 50% of those with glaucoma are diagnosed. Roughly half with   glaucoma are under 50.
  • AMD –2.5 million Canadians are living with AMD. It is the leading cause of blindness in Canada typically affecting older Canadians. Risk factors are smoking, age (50+), race (Caucasian), and family history.

  • Diabetic Retinopathy–1 in 3 Canadians have diabetes or prediabetes, 50% of those 20 years old will develop diabetes in their lifetime, and it is the leading cause of legal blindness in people of working age.

These diseases are typically asymptomatic in their early stages, which means some individuals are not diagnosed. If diagnosed and treated early, glaucoma, AMD and diabetic retinopathy can be managed to mitigate the impact on vision. Screening prior to diagnosis that includes OCT and retinal photos, are not currently covered by most group and provincial health plans. As a result, a diagnosis may be delayed. Similarly, provincial coverage after diagnosis does not always reimburse OCTs and retinal photos which will help an optometrist monitor the progress of all three disease after diagnosis. There are even more tests required for those with a glaucoma diagnosis, several of which are not covered provincially.

With an early diagnosis, treatments to slow down the progression of glaucoma, AMD, and diabetic retinopathy can be very effective. Without reimbursement some Canadians will not be diagnosed early and are therefore at risk of disease progression which can lead to premature blindness.

The Canadian Association of Optometrists (CAO) recommends that plan sponsors, insurers, and group benefit advisors review group vision care plans regularly to identify and fill any gaps in provincial coverage. Doing so will ensure that plan members and their dependents have access to the services of an optometrists for routine eye examinations, follow-up visits, and additional diagnostic testing, monitoring, and treatment for serious eye diseases.

CAO represents more than 80% of optometrists across Canada who are committed to the health of Canadians. If you require any assistance, have any questions, or would like to consult with the CAO on how to examine your vision care plan for gaps in care and help modernize it, please do not hesitate to reach out to us at

You can listen to the webinar and access other materials from the CAO at

Click here to download the related PDF