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Ontario Coverage for Cataract Surgery with Astigmatism
Liz wrote:
My 84 year-old mother needs surgery to correct cataracts but she also has astigmatism. She has been told that there are 2 options 1) new lenses implanted to correct the cataract problem 2) new lenses that will correct both problems at the same time. The problem is that the second option is not covered by OHIP and she will need to pay the Herzig Inst. $3000 to have it done privately. My questions: 1. Is this true – lenses/procedures to handle both are not covered…? 1. If she elects to have it done, what are her options. Is the only option an Institute like Herzig or can she not work directly with an ophthalmologist at a Toronto hospital? Many thanks.
Canadian Association of Optometrists's response:
Your mother has a range of options to deal with her current situation. Most ophthalmologists offer the ability for their patients to have surgery done through their local hospital. In this scenario, OHIP would cover the cost of a conventional intra-ocular lens implant, as well as most of the expenses involved with the surgical procedure. There may be incidental costs for supplement testing that will give the surgeon valuable information about your mother’s eyes to enable them to maximize the chance of success. For a patient with a high amount of astigmatism though, a conventional implant would likely not correct her entire prescription. She would likely have to wear glasses afterwards to fine tune her distance & close vision. If your mother wanted to reduce her dependence on glasses as much as possible, she would have to opt for a premium lens that would be specially designed to try to treat the astigmatism. These types of lenses are not currently covered by OHIP, so the patient would have to cover the difference themselves. There are some surgeons who offer these premium lenses at the hospital. Other surgeons, such as the ones at Herzig, do the surgery in their independent clinic.
You may wish to consult your local optometrist to determine the most suitable option for your mother. There needs to be an important discussion with your mother about her expectations regarding this surgery, as well as her current visual demands. If her visual demands are modest and she doesn’t mind wearing glasses afterwards, perhaps a conventional lens implant would be sufficient. If she is particularly active and would prefer to have increased freedom from glasses, then the added expense of a premium lens implant would need to be considered. A local optometrist would also be familiar with other surgeons in your area, if you choose to consider other alternatives.
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Kim wrote:
I have a tiny bubble with tiny grey dot in the center… it’s on my left corner of my eye closest to my nose. What could this be? I have no pain or redness.
Dr Carol Doman's response:
Kim,
You should definitely have this assessed by your optometrist. It could be something as simple as a cyst, but if it’s something more serious further follow up or treatment may be required.
Dr. Doman
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Strabismus Surgery
I'm an adult with strabismus, and lately I've seen quite a few blogs on YouTube of pre/post op strabismus procedure. I have 80% depth perception, and to be honest it's more of a psychological ailment than a physical one. Is this something that you would recommend for me? The few contacts I spoke to said it's quick, easy, generally quick recovery and they would do it every single year if they had too.
Any information you could give me about this procedure, such as contacts, price, pro/cons, risks, ect would be greatly appreciated.
Dr Henry Smit's response:
Dear Dave:
If you have 80% depth perception, it would seem to me that your eyes are likely aligned part of the time, or had been aligned at some time in the past. The chance of success with strabismus surgery tends to improve if the eyes have a pre-existing ability to co-ordinate and work together – which it appears that yours have.
Your first step should be to consult an optometrist to have a binocular vision assessment. He or she will be able to measure the degree of strabismus as well as your binocular depth perception. Based on the results of your assessment, your optometrist can refer you to an eye surgeon who will be able to discuss the potential benefits and risks of doing the surgery in your particular case. The benefits and risks vary from case to case based on the degree of misalignment and the direction of misalignment. However, based on your 80% depth perception, it appears that the possibility of corrective surgery is an option worth investigating in your case.
Best of luck,
Dr. Smit
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