Ilex Eye: Eye Doctors in Waterloo

General Questions

My optometrist recommended some special testing that isn’t covered by OHIP. What’s involved, and why is it important?

At Ilex Eye Associates, we employ several special testing procedures to provide the best care possible. For some patients, there may be full or partial OHIP coverage; for others, it may be an out-of-pocket expense, or billed to a third party plan.

  • Automated Visual Field (AVF) Analysis: maps the peripheral (side) vision, and is a critical component of diagnosing and monitoring any disease affecting the optic nerve, including neurologic deficits and glaucoma.  AVF analysis is an OHIP-insured service for patients 19 and under, 65 and over, and adults with medical conditions qualifying them for OHIP coverage.
  • Pachymetry: measures the central corneal thickness (CCT), essential in the diagnosis of glaucoma and helpful in diagnosing and monitoring many diseases of the cornea. Pachymetry is not an OHIP-insured procedure for any patient.
  • Digital Retinal Imaging (photography): provides a high-resolution digital image of the retina that is of great value in diagnosing and monitoring diseases affecting the retina and optic nerve including diabetes, age-related macular degeneration (AMD), and glaucoma.  Photography is not an OHIP-insured procedure for any patient.
  • Optical Coherence Tomography (OCT): provides a non-invasive and high-resolution cross-sectional image ... think of OCT as an optical ultrasound. It has become invaluable in the diagnosis and management of a number of retinal and optic nerve diseases, including glaucoma, AMD, diabetic retinopathy, and others. Like photography, OCT is not an OHIP-insured service for any patient.

Our fees for these procedures mirror those charged for other non-insured partial assessments: between $25 and $60. Particularly for seniors and patients with diabetes, the care OHIP covers is no longer the best care available ... in fact, it often falls far short. Regardless, our priority will remain providing the highest standard of care available to each and every patient.

Your optometrist will only recommend these procedures when there are strong clinical benefits that improve the quality of your care. We partner with you in all decision-making, and it is always your prerogative to decline any procedure, insured or otherwise. That being said, we trust that you recognize that our recommendations are made with your best interests in mind.

So, if I can see 20/20, why do I need to get my eyes checked? Can’t I just wait until I have blurry vision and call for an appointment?

It’s important to remember that 20/20 vision doesn’t necessarily mean that your eyes are healthy. In fact, as many as one in six people with potentially serious eye disease still have ‘normal’ visual acuity.

Many serious conditions have no symptoms at all: no blur, no redness, no headache, no pain, no tearing … nothing. Glaucoma, age-related macular degeneration, and diabetic retinopathy are examples of conditions that are usually discovered through regular comprehensive examinations. A significant amount of damage can occurs before symptoms become evident: damage that is often preventable with early diagnosis and treatment.

For this reason, we recommend comprehensive examinations at regular intervals for patients of all ages. As a rule, children and seniors should be seen annually (and are insured by OHIP at this schedule), and adults at least every two years or as recommended by the optometrist.

Your mother was right, yet again: an ounce of prevention is worth a pound of cure.

What does ‘20/20’ mean, and why can some people who need to wear glasses see better than some people who don’t?

This may be the most commonly asked question during an eye exam (aside from ‘which is better, one or two?’). We’ve all heard about 20/20, or 20/40, but what do these numbers really mean?

The two numbers both refer to distance measurements, in feet: the top number is always 20, because 20 feet is the usual testing distance when reading the eye chart during the exam. The bottom number is the distance from which a person with ‘average’ vision is able to see the same size letter. For example, if your visual acuity is 20/20, you are able to read the same letters from a distance of 20 feet that can be read by a person with average vision at 20 feet. However, if your acuity is 20/40, you need to be at 20 feet to see what a person with average vision can see from a distance of 40 feet.

Many people assume that 20/20 is ‘perfect’, but a better description would be ‘average’: 20/20 is what the majority of the population is able to read when their prescription is properly corrected. Some people are able to see 20/15, while some may only manage 20/25, depending on the quality of the optics of their eye (much like some cameras or films have better resolution than others) ... and that’s why someone with glasses may actually see a little better than someone who doesn’t need glasses at all.

Will wearing glasses make my eyes weaker? Won't I become dependent on my glasses if I wear them too much?

It's a common misconception that wearing glasses will make your eyes weaker. Rest assured that your eyes will not 'adapt' to the prescription, and need stronger and stronger glasses after every examination. This misunderstanding likely stems from the fact that many nearsighted people do require stronger glasses every year or so during their school years. However, this is likely simply a function of physical growth, not adaptation to the current prescription. As we grow, and our eye lengthens, our prescription increases.

Many patients between age 20 and 40 will return a year or two after obtaining glasses for reading or working on the computer, saying 'I can't get by without my glasses anymore'. However, the examination will often show little or no change in their eyes ... their glasses simply make things easier to see and they like wearing them.

Needing to wear reading glasses more as we get older is completely normal, and all but unavoidable ... but again, wearing glasses has no positive or negative impact on your eyes in the long run.

Providing an eye care experience

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