Health Systems and Policy Monitor (HSPM)

An innovative platform that provides a detailed description of health systems and provides up-to-date information on reforms and changes that are particularly policy relevant. In parallel, the Health Reform Tracker (see the Tracker tab) provides an overview of health reforms in over 30 countries across the WHO European Region and North America. For detailed information on country policy responses to the COVID-19 pandemic during 2020-2021, see our separate COVID-19 Health Systems Response Monitor (HSRM).

Updates

Back

A proposal to increase scope of practice for optometrists in Ontario

28 November 2025 | Country Update

Ontario is considering expanding optometrists’ scope to prescribe topical and oral medications, remove superficial corneal foreign bodies, manage open-angle glaucoma, order diagnostic tests and perform select in-office procedures such as laser therapy and minor non-intraocular surgery. The reform aims to address long wait times for ophthalmologists and overburdened emergency departments. Between 2010 and 2020, patients waiting for ophthalmological surgery in Ontario increased by 74%, with cataract, vitreoretinal and strabismus surgeries facing the longest delays. The goal is to improve timely access, reduce unnecessary referrals and ease hospital pressure, particularly in rural or underserved areas. Supporters, including the Ontario Association of Optometrists and the College of Optometrists of Ontario, argue the changes reflect modern training and will enhance efficiency. Critics, notably the Canadian Ophthalmological Society, warn surgical and laser procedures require specialized expertise and could pose safety risks. Proposals submitted in 2024 remain under consultation, with no enacted changes or outcome data.