What is the difference between an optometrist and an ophthalmologist?

An optometrist is a regulated primary eye care provider who performs comprehensive eye exams, diagnoses and manages eye diseases, and prescribes glasses and contact lenses. An ophthalmologist is a medical doctor who specializes in eye surgery and the medical management of complex or surgical eye conditions. Most patients start with their optometrist, who refers to an ophthalmologist when surgery or specialist care is needed.

What does an optician do?

An optician is a regulated specialist trained to interpret optical prescriptions, fit and dispense glasses and contact lenses, and adjust and repair frames. Opticians work from prescriptions written by optometrists or ophthalmologists — they do not examine eyes or diagnose conditions. Many optometry clinics have an optician on staff to provide seamless prescription fulfillment.

Do I need a referral to see an ophthalmologist in Ontario?

In most cases, yes. Ophthalmologist appointments in Ontario typically require a referral from an optometrist or family doctor. Your optometrist handles this directly and can often expedite urgent referrals for conditions like retinal detachment, acute glaucoma, or rapidly worsening diabetic retinopathy.

Does OHIP cover visits to an optometrist, ophthalmologist, and optician?

OHIP covers optometrist visits for children under 20 and adults over 64, and for adults of any age with qualifying medical conditions. OHIP covers medically necessary ophthalmologist visits regardless of age. Optician services (glasses, contact lens fittings) are not covered by OHIP but may be covered by private benefits.

What eye conditions does an optometrist treat without referral?

Optometrists in Ontario are authorized to diagnose and manage a wide range of conditions including dry eye, glaucoma (monitoring and prescribing drops), diabetic retinopathy (monitoring), conjunctivitis, blepharitis, corneal conditions, and most common refractive errors. They refer to ophthalmologists when surgery or advanced medical management is required.

Optometrist vs Ophthalmologist vs Optician

Ontario's eye care system involves three distinct regulated professions. Understanding who does what helps you navigate care efficiently — and in most cases, your optometrist is your starting point and ongoing primary provider.

Optometrists: primary eye care

An optometrist (OD) is a Doctor of Optometry — a regulated health professional who has completed an undergraduate degree and a four-year professional program at an accredited optometry school. In Ontario, optometrists are regulated by the College of Optometrists of Ontario.

What an optometrist does:

Comprehensive eye exams for all ages
Diagnosis and management of eye diseases (glaucoma, dry eye, diabetic retinopathy, macular degeneration, and more)
Prescribing glasses and contact lenses
Prescribing therapeutic medications (eye drops, antibiotics)
Detecting systemic conditions with ocular manifestations (diabetes, hypertension, multiple sclerosis)
Co-managing patients before and after eye surgery
Referring to ophthalmologists when surgical or specialist care is needed

For most Ontarians, the optometrist is the only eye care provider they will ever need. Routine and many complex conditions are managed entirely within optometry.

Ophthalmologists: surgical and specialist care

An ophthalmologist (MD) is a medical doctor who completed medical school followed by a residency in ophthalmology (5+ years), and often a fellowship in a subspecialty. They are regulated by the College of Physicians and Surgeons of Ontario.

What an ophthalmologist does:

Eye surgery (cataract removal, LASIK, corneal transplant, retinal detachment repair, glaucoma surgery, and more)
Medical management of complex or advanced eye disease
Specialist consultations requested by optometrists and family doctors

Common referral pathways from optometrists to ophthalmologists:

Retinal detachment — requires surgical repair (pneumatic retinopexy, scleral buckle, vitrectomy); OHIP-covered
Cataracts — once vision is significantly affected, referral for OHIP-covered surgical removal
Corneal transplant (keratoplasty) — for conditions like keratoconus or corneal scarring; OHIP-covered
Advanced glaucoma — when drops and laser are insufficient, surgical options are considered
LASIK and PRK — refractive surgery to reduce or eliminate dependence on glasses; performed by ophthalmologists, not covered by OHIP
Cosmetic procedures — eyelid surgery (blepharoplasty), ptosis repair; OHIP coverage depends on whether the indication is medical or cosmetic

Referrals from ophthalmologists back to optometrists are also common — for ongoing monitoring of stable conditions, post-surgical co-management, and routine care between specialist appointments.

Opticians: fitting and dispensing

An optician is a regulated professional trained specifically in the fitting and dispensing of corrective lenses. Opticians are regulated by the College of Opticians of Ontario.

What an optician does:

Interprets and fills optical prescriptions from optometrists or ophthalmologists
Measures facial geometry and pupillary distance for lens centration
Advises on frame selection, lens materials, coatings, and designs
Fits and adjusts frames
Repairs and modifies eyewear
Fits contact lenses from an existing contact lens prescription

What an optician does not do:

Examine eyes
Diagnose or treat eye conditions
Write prescriptions

Many optometry clinics — including Spadina Optometry — have a licensed optician on staff. This means you can complete your eye exam, receive your prescription, and have your glasses or contact lenses fitted in a single visit, with all three steps coordinated by a team who knows your prescription and history.

How they work together

A typical patient journey illustrates the collaboration:

Optometrist performs your comprehensive exam, identifies early glaucoma, initiates treatment with eye drops, and monitors annually
If drops are insufficient, optometrist refers to an ophthalmologist for laser or surgical intervention
Post-surgery, the ophthalmologist co-manages with your optometrist for ongoing monitoring
Throughout, the optician at your clinic provides updated glasses as your prescription changes

This coordinated model means patients receive appropriate care at each level without unnecessary delays or costs.

Who to contact first

For almost all eye care needs in Ontario — routine exams, new symptoms, ongoing conditions, or questions about whether you need specialist care — start with your optometrist. They will direct you appropriately.

For acute emergencies (sudden vision loss, retinal detachment symptoms, chemical eye injury), go directly to a hospital emergency department or urgent eye care clinic.

Optometrist vs Ophthalmologist vs Optician in Ontario: Who Do You See?