Offer your patients improved access to eyecare by directly requesting a comprehensive eye exam with a Doctor of Optometry
Eye health can be an indicator of a patient’s overall health, which is why collaboration among doctors of optometry and other primary healthcare team members is crucial to optimizing patient care.
This is especially true when it comes to managing eye disease, providing rehabilitative treatment and arranging timely requests to ophthalmologists.
As the profession that provides the majority of the primary eye care in BC, doctors of optometry are acutely aware of how many patients go to emergency rooms or walk-in clinics to have their eyes examined and conditions treated instead of visiting an optometrist. In BC, optometry’s new services agreement and payment schedule with the provincial government provide improved access to eye care by allowing physicians to make a direct request to an optometrist when medically necessary.
MSP Benefit Details
Access a full list of diagnostic codes for medically required eye examinations. With your request, patients will receive medically necessary eye care in a timely manner. Urgent referrals can often be seen on the same day upon request.
Criteria
In general, the criteria for medically required requests include:
- Ocular disease, trauma or injury
- Systemic diseases associated with significant ocular risk (e.g., diabetes)
- Medications associated with significant ocular risk conditions
Conditions
Some conditions that qualify for a direct request are:
- Annual diabetic retinal exams
- Foreign body removal and/or eye injuries
- Diagnosis and medical treatment of chronic dry eyes
- Bacterial/viral/allergic conjunctivitis
- Glaucoma
- Cataract follow-up care
- Refraction or routine eye exams are not available for direct request.
Criteria
In general, the criteria for medically required requests include:
- Ocular disease, trauma or injury
- Systemic diseases associated with significant ocular risk (e.g., diabetes)
- Medications associated with significant ocular risk Conditions
Conditions
Some conditions that qualify for a direct request are:
- Annual diabetic retinal exams
- Foreign body removal and/or eye injuries
- Diagnosis and medical treatment of chronic dry eyes
- Bacterial/viral/allergic conjunctivitis
- Glaucoma
- Cataract follow-up care
- Refraction or routine eye exams are not available for direct request.
How to Complete a Request for a Doctor of Optometry
Write the required note to a specific doctor of optometry or clinic, or to “optometry” in general, stating the medically necessary reason for the request.
After examining the patient, the doctor of optometry will send you a written report. You will also be notified if a specialist referral is required (i.e., ophthalmology, neurology), ensuring continuity of care for your patients.
Additional Takeaways
- Remember that MSP provides an insured benefit for routine eye exams for children under the age of 19 years and adults 65 years and older. Click here for more information.
- The CNIB estimates that vision loss costs the country’s economy $19.1 billion annually (one per cent of Canada’s GDP), of which $11 billion is direct health system costs.[1] Vision loss costs the BC government over $2.6 billion annually or approximately $575 per BC resident, the third highest rate in Canada.[2]
Please note there may be an additional fee charged to the patient in addition to the MSP benefit.
[1] Deloitte Access Economics. The Cost of Vision Loss in Canada (2012). Report for CNIB. Canberra, 2013.
[2] Deloitte Access Economics. The Cost of Vision Loss in Canada (2012). Report for CNIB. Canberra, 2013.