Diabetes and Eye Health: What Ontario Patients Need to Know
Diabetes is the leading cause of preventable vision loss in Canadian adults. Annual dilated eye exams are OHIP-insured for diabetic patients and are the most important step in protecting your sight.
Updated · Dr. Ema Hazra
Approximately 1.3 million Ontarians live with diabetes, and diabetic eye disease is the leading cause of preventable vision loss in Canadian working-age adults. The critical fact: diabetic retinopathy causes no symptoms in its early, most treatable stages.
How diabetes damages the eye
High blood sugar over time damages the small blood vessels throughout the body — including the retina. In the eye, this causes a condition called diabetic retinopathy, which progresses in stages:
Non-proliferative diabetic retinopathy (NPDR)
The early stage. Damaged blood vessels develop microaneurysms (small bulges) that may leak fluid or blood into the retina. Vision may be normal at this stage.
Diabetic macular edema (DME)
Fluid accumulates in the macula — the central region of the retina responsible for sharp vision. This can cause blurred central vision and is the most common cause of vision loss in people with diabetes.
Proliferative diabetic retinopathy (PDR)
The advanced stage. New, fragile blood vessels grow on the retina and into the vitreous. These vessels bleed easily and can cause severe vision loss, retinal detachment, or neovascular glaucoma.
OHIP coverage for diabetic eye exams
If you have diabetes, your annual dilated eye exam is fully covered by OHIP — no referral required. This includes:
- A comprehensive examination with dilation
- Retinal photography in most clinics
- Referral to an ophthalmologist if retinopathy is detected
Do not skip this exam even if your vision feels fine. Retinopathy is asymptomatic until it is advanced.
What to expect at a diabetic eye exam
Your optometrist will:
- Dilate your pupils to examine the retina directly
- Photograph the retina (retinal photos are the best record of change over time)
- Check for macular edema using OCT (optical coherence tomography) if indicated
- Measure your intraocular pressure (diabetes increases glaucoma risk)
Bring your most recent HbA1c result if you have it — this gives your optometrist important context.
Other diabetic eye conditions
Beyond retinopathy, diabetes increases the risk of:
- Cataracts — developing earlier and progressing faster than in the general population
- Glaucoma — people with diabetes are twice as likely to develop glaucoma
- Fluctuating vision — blood sugar swings can temporarily change the shape of the lens, causing variable blur
Key message
Annual eye exams save sight. In Ontario, they cost you nothing if you have diabetes. Book your exam — ideally at the same time each year so changes can be tracked systematically.
Toronto Eye Care
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Spadina Optometry serves patients across Toronto and the surrounding area. Our optometrists provide comprehensive eye exams, contact lens fittings, and more.
Book an appointment →Frequently Asked Questions
- Does OHIP cover eye exams for people with diabetes in Ontario?
- Yes. Adults with diabetes are eligible for annual OHIP-insured eye exams regardless of age. Your optometrist bills OHIP directly. You do not need a referral from your family doctor.
- What is diabetic retinopathy?
- Diabetic retinopathy is damage to the blood vessels in the retina caused by high blood sugar over time. Early stages cause no symptoms. As it progresses, blood vessels can leak, swell, or grow abnormally, leading to blurred vision, dark spots, or vision loss. It is the most common diabetic eye complication.
- How often should someone with diabetes get their eyes checked?
- The Canadian Diabetes Association recommends a dilated eye exam at least once per year for all people with Type 1 or Type 2 diabetes. More frequent exams may be recommended if retinopathy is detected or blood sugar control is poor.
- Can diabetic eye disease be treated?
- Yes, when caught early. Laser photocoagulation, anti-VEGF injections (such as Eylea or Lucentis), and vitrectomy surgery are all effective treatments for advanced diabetic retinopathy or diabetic macular edema. Early detection through annual exams is critical because treatment is most effective before symptoms appear.
- Can blood sugar control improve diabetic retinopathy?
- Improving blood sugar control (HbA1c), blood pressure, and cholesterol can slow the progression of diabetic retinopathy and reduce the risk of vision-threatening complications. Tight glycemic control is the single most effective intervention for preventing diabetic eye disease.
Author
Dr. Ema Hazra, OD — Pending clinical review
Optometrist, Spadina Optometry
A Toronto native, Dr. Ema Hazra earned her Doctor of Optometry from the University of Waterloo in 2018 and returned to Spadina Optometry — where she had previously interned — bringing experience from an ocular disease externship at Eye Associates of Pinellas in Florida alongside leading ophthalmologists specializing in glaucoma, macular degeneration, and retinal disease. Her clinical interests include myopia control, specialty contact lenses, dry eye disease, and refractive surgery, and she is passionate about providing comprehensive care for patients of all ages, especially children.