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Is Glaucoma Surgery Covered by OHIP?

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Senior woman has her eye pressure tested with a tonometer.

Glaucoma is an eye disease that can sneakily steal your vision, but many surgeries can help manage this condition. Protecting your vision is essential, but it’s common to worry about the cost of surgery—eye care isn’t fully covered under the national healthcare system. Thankfully, Ontario’s insurance plan can help.

The Ontario Health Insurance Plan (OHIP) covers many, but not all, glaucoma treatments. Your eye doctor can help refer you for surgery and determine your eligibility for OHIP coverage

OHIP helps many Ontario residents afford crucial optometry services, so it’s important to understand your coverage. 

OHIP Covers Many Necessary Treatments

OHIP is a publicly funded healthcare program that provides many medical services. It covers medically necessary services, including primary care and specialist physician treatment, diagnostic tests, surgeries, hospital stays, and emergency care. 

OHIP covers all or part of the cost for the following services: 

  • Doctor visits
  • Hospital stays
  • Lab testing
  • Eligible dental surgeries
  • Eligible optometry services
  • Podiatry services
  • Ambulance services

Most Ontarians are eligible for a covered eye exam yearly and many other services. According to the Government of Ontario, OHIP will help with the following eye-related conditions

  • Diabetes mellitus
  • Glaucoma requiring treatment with medication, laser (excluding prophylactic laser peripheral iridotomy), or surgery
  • Cataracts with a visual acuity of 20/40 or worse in the best-corrected eye or when you receive a surgery referral
  • Acute or chronically progressive retinal disease
  • Acute or chronically progressive corneal disease
  • Uveitis that is acute or chronic during episodes of active inflammation
  • Acute or chronically progressive optic pathway disease
  • Acquired cranial nerve palsy resulting in strabismus during the acute phase or until the condition resolves or stabilizes
  • Ocular drug toxicity screening for patients taking hydroxychloroquine, chloroquine, ethambutol, or tamoxifen

What Is Glaucoma Surgery? 

Glaucoma is a group of eye diseases that damage your optic nerve, the part of your eye that sends signals to your brain to help you see. Many, but not all, forms of glaucoma raise your intraocular pressure (IOP). 

Glaucoma causes vision loss as it progresses, but many forms of this disease show limited symptoms until vision loss occurs. Regular eye exams are essential for helping diagnose glaucoma as early as possible—your optometrist has the tools to notice small changes in your eyes that you can’t see alone. Vision loss caused by glaucoma is permanent, so don’t avoid going to the eye doctor. 

When your optometrist diagnoses glaucoma, they recommend a customized treatment plan to help protect your vision. This treatment plan varies depending on the type of glaucoma you have and the severity of your condition. 

There are many types of glaucoma, and the one you have will affect what surgery meets your needs. 

Your eye doctor may recommend one of the following surgeries if you have glaucoma: 

  • Trabeculectomy: Trabeculectomy is ideal for patients with open-angle glaucoma. This procedure involves creating a channel to help excess fluid drain from the eye more effectively. 
  • Glaucoma implant surgery: Glaucoma implant surgery may be recommended to patients with various forms of glaucoma. This treatment involves implanting a small tube in the eye to lower eye pressure, helping fluid drain more efficiently. 
  • Minimally invasive glaucoma surgery: Minimally invasive glaucoma surgery is ideal for mild cases of glaucoma. During treatment, your surgeon completes several micro incisions in the eye to relieve eye pressure. 
  • Cyclophotocoagulation: Cyclophotocoagulation targets both eye pressure and fluid production. During treatment, your surgeon uses a laser to lower eye pressure and slow future fluid production in the eye. 
Close up eye with close angle glaucoma.

What Can You Expect During Glaucoma Surgery? 

If you’ve been diagnosed with glaucoma, you may be wondering what to expect during the surgical process. These procedures are generally done on an outpatient basis and don’t take long to perform. 

Each surgery is different—your experience will differ depending on the surgery your optometrist recommends. 

After surgery, you will receive aftercare instructions and any necessary medications for recovery. Many patients receive prescription eye drops to help prevent infections and swelling. Expect to avoid more strenuous activities like exercise for a few weeks as you recover. 

You will have regular check-ups with your optometrist to ensure you’re healing well and not experiencing any side effects. It’s common to experience some soreness and swelling, but your eye doctor will monitor for potential issues with the cornea or low eye pressure as you heal. 

Diagnose Glaucoma as Early as Possible

Glaucoma can potentially steal your sight if left untreated, but it can be difficult to identify alone. Your eye doctor has the tools available to diagnose eye disease as early as possible, so don’t forget to book regular eye exams—they’re essential for protecting your eye health and vision. 

Your optometrist can diagnose glaucoma, determine your eligibility for surgery, and provide information on whether or not your procedure has coverage with OHIP. Contact St. Clair Eye Clinic if you have concerns about glaucoma or your vision.

Written by Erez Elias

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