• COVID-19 & Optometry Care
    Information for patients and optometrists:
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  • COVID-19 Return to Work

    Return to Work Guidance Document

    Return to Work: Infection Prevention and Control for Optometric Practice provides optometrists with guidance for working during the ongoing COVID-19 pandemic. The contents of this guidance will be reviewed and updated as Ontario progresses through each phase of its recovery, and as new guidance or recommendations are made available by the provincial government.

    Optometry practices must comply with both the College’s Return to Work guidance and the Ministry of Health guidance COVID-19 Operational Requirements: Health Sector Restart, including the MOH Patient Screening document.


    Frequently Asked Questions

     

    COVID-19 Symptoms and Exposure

    What protocol should I follow if I’ve been notified that a patient or staff/optometrist has tested positive for COVID-19?
    Below is a list of resources that provide guidance on next steps following a positive COVID-19 exposure. Each situation is unique; if optometrists are unclear how to proceed after reviewing these resources, they should use their best judgment to inform decisions regarding testing, isolation, and office closure.

    Following exposure to COVID-19:

    • Anyone exposed to COVID-19 can follow this simple, four-step process.
    • Specific to health care providers:
      • A confirmed case in an optometrist or staff should be reported to your local Public Health unit, which will provide you with specific guidance regarding contact tracing.
      • The Ministry of Health has guidance on contact management based on exposure setting (e.g., health care), exposure type (protected/unprotected), and specific scenarios (e.g., patient vs health care worker is the positive case),  on Table 5 (page 29-30).
      • Optometrists may also want to review the “Health Human Resources” section in the Ministry of Health’s Operational Requirements to inform their return to work planning.

    What if an optometrist or staff becomes ill with COVID-like symptoms?
    Optometrists and their staff must not present to work when ill with symptoms of infection. Any person with symptoms of COVID-19 should stay home, contact their primary care provider or their local Public Health Unit, and should not return to work until they are asymptomatic and have been cleared by their primary care provider or Telehealth Ontario of any concern of COVID-19. Any confirmed case of COVID-19 in an optometrist, staff, or visitor to the office should be reported to the local Public Health Unit. Optometrists should follow the subsequent directions of their local Public Health Unit.


    Vaccination

    Where can I find resources about the COVID-19 vaccines and/or provincial vaccination program?
    Information about COVID-19 vaccination is available here for health care providers, including specific information about prioritizing vaccination among health care workers.

    How should optometrists and staff deal with symptoms within 48 hours of receiving a COVID-19 vaccine?
    Health care providers can review the following guidance from the Ministry of Health regarding symptoms following vaccination.


    Personal Protective Equipment and Masks

    Where should I purchase personal protective equipment (PPE) and what brands are recommended?
    The College is not in a position to recommend or approve certain types/brands or PPE suppliers. Public Health Ontario has resources related to infection control practices that may be helpful to optometrists. Mouth, nose, and eyes must be covered by PPE. Prescription glasses are not acceptable as eye protection unless they are equipped with side shields.

    The provincial government has developed a PPE supplier directory.  In addition, the Ontario Association of Optometrists (OAO) is working to provide optometrists with information on accessing PPE.

    Optometric colleagues, interprofessional colleagues, and the OAO may be able to answer specific questions or provide recommendations as to PPE currently in use.

    What is the appropriate way to don/doff PPE?
    Public Health Ontario has numerous resources (both in print and video) on proper technique for donning and doffing PPE:

    What is considered suitable eye protection?
    The College is not in a position to recommend certain brands of PPE. Eye protection should cover both the front and sides of the face and includes safety glasses, safety goggles, face shields and visors attached to masks. Prescription glasses are not acceptable as eye protection.

    If a patient arrives to an appointment without a mask, do I cancel the appointment?
    If a patient arrives without a mask, optometrists should provide patients with a mask to wear. If the optometrist is unable to provide a mask, the appointment should be rescheduled or cancelled, or provided using virtual consultation if possible.

    If a patient doesn’t bring their own mask, can I charge them for a mask I provide?
    Providing equipment and supplies needed to control the spread of infection (such as personal protective equipment/masks) is a part of OHIP-insured services. Optometrists cannot charge OHIP-insured patients for these services as that would be considered extra-billing.

    Any fees charged to patients who are not OHIP-insured must be reasonable and not excessive. Optometrists must consider the patient’s circumstances and access to care when determining fees. Patients should be informed of any fees in advance of an appointment.

    What if a patient cannot wear a mask?
    Optometrists are required to accommodate patients who are unable to wear masks due to a disability.

    In accommodating patients with disabilities, optometrists should assess the situation to determine what the patient needs while keeping themselves, staff, and other patients safest. Depending on the nature of the appointment, optometrists may be able to provide care virtually, or recommend deferring the appointment to a later date if the issue is not urgent.

    If an optometrist determines that an in-person appointment is absolutely necessary, the appointment can be scheduled either outside of regular office hours or when no other patients and fewer staff are present.

    There may be rare cases where an optometrist cannot accommodate such patients. For example, if an optometrist is immunocompromised due to a health condition, or if an optometrist is unable to get vaccinated for health reasons. In these cases, optometrists can refer patients to another optometrist who is able to accommodate in-person appointments for patients whose disability prevents them from wearing a mask. Contact the College for information about optometrists in your area who have identified that they can provide such care.

    What if a patient insists that it is their human right to receive a service without wearing a mask?
    The Ontario Human Rights Commission (OHRC) has an FAQ that outlines human rights concerns related to COVID-19. This FAQ notes that:

    • …any requirements related to health and safety and COVID-19, such as wearing a mask…do not generally cause concern under the Code.
    • …service providers should recognize that health and safety requirements such as masks may have a negative impact on vulnerable populations identified by a ground under the Code who may not have access to such equipment… and
    • …the Ministry of Health advises that face coverings should not be placed on or used by children under the age of two, anyone who has trouble breathing, or anyone who is unable to remove it without assistance.

    Read the full FAQ on the OHRC website.


    Travel

    Can we see patients who live in other provinces?
    Yes. The Ministry of Health Patient Screening document no longer lists travel outside of Ontario as a positive screening result.

    Can optometrists and staff work if they travel between provinces?
    Health care workers and staff can continue to work, but should self-monitor for symptoms and ensure they are screening patients and wearing appropriate personal protective equipment (PPE). Anyone who develops symptoms should self-isolate and contact their primary care provider or their local Public Health Unit.

    Can we see patients who travel from outside of Canada?
    Fully immunized patients* do not need to be screened for travel. Please see the Ministry of Health Patient Screening Guidance Document for more information on screening patients.

    * A fully immunized individual is defined as any individual >14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series (i.e., Johnson and Johnson).

    Can an optometrist work if they have travelled outside of Canada?
    Anyone who has travelled outside of Canada is required to self-isolate for 14 days upon their arrival back in Canada. Travellers who are fully vaccinated and meet specific requirements may be exempt from quarantine requirements as per federal guidelines.

    As per federal guidance, optometrists who are unvaccinated should not directly care for persons 65 years of age or older within the 14-day period that begins on the day on which they enter Canada.


    Clinical Care

    Optometrists are now able to resume new contact lens fittings. What are the best ways to manage this while ensuring physical distancing from patients and suitable infection prevention practices?
    The College has revised its guidance so that new contact lens fittings are no longer prohibited, however, we recognize these fittings pose some challenges re: physical distancing and uncertain duration. When providing contact lens fittings, optometrists could consider measures that would limit the time in close contact with patients, including:

    • Providing some of the contact lens training via virtual consultations (i.e., video instruction)
    • Using complementary instruction videos before (e.g., insertion and removal techniques) and/or after (e.g., cleaning lenses) the training
    • Using barriers (such as Plexiglass) within the office setting to separate optometrists/staff from patients learning insertion/removal
    • Using gloves and other PPE that may add additional protection and align with patient expectations (see: guidance from the British Contact Lens Association)

    Can I use a combination of fundus photography and imaging technology (e.g., OCT) for all patients as the only method of examining the fundus, or as a substitute for dilated fundus examination?
    No. The standards of practice regarding pharmacologic dilation are unchanged and may be reviewed under OPR 6.2. Please also refer to the College’s Policy on Digital Imaging/Fundus Photography in Optometric Practice.


    Disinfecting

    Is it OK to use 3% hydrogen peroxide to clean and disinfect Goldmann tonometer prisms? This is not included among the examples cited under high- and low-level disinfectants in the College’s guidance (Control of the Environment).
    Generally speaking, the answer is yes. Many of the examples of high-level disinfectants will only be appropriate for hard surfaces and will damage clinical equipment (e.g., tonometer probes). Optometrists should refer to manufacturer and best-practice professional guidelines, and use their clinical judgment regarding choice of cleaning and disinfecting agents.  Optometrists should avoid cleaning and disinfecting agents (and/or contact times) that will damage clinical equipment.

    Is it OK to clean and disinfect eyeglass frames using soap and warm water? This is not included among the examples cited under high- and low-level disinfectants in the College’s guidance (Control of the Environment).
    Soap and water is sufficient to clean eyeglass frames. Optometrists should still refer to manufacturer and best-practice professional guidelines, and use their clinical judgment regarding choice of cleaning and disinfectant agents and/or cloths.  Optometrists should avoid cleaning and disinfecting agents (and/or contact times) that will damage clinical equipment or eyeglass frames (of various materials). Cleaning alone is not sufficient, disinfection alone does not replace cleaning, and any contact points should be cleaned and disinfected.

    For further information, refer to the following Centers for Disease Control and Prevention Science Brief.

    Questions relating to practice management (e.g., billing) should be directed to the Ontario Association of Optometrists.