Roadmap for Change

01. Committed Leadership: Establishing a Strategic Steering Committee

We recommend that the federal government establish a Strategic Steering Committee composed of people with lived experiences, vision health leaders, vision health professionals including ophthalmologists, optometrists, opticians, orthoptists, vision rehabilitation and habilitation therapists, client care navigators, orientation and mobility specialists, low vision specialists, researchers, and others to oversee implementation, provide strategic guidance and support the successful execution of the National Strategy for Eye Care over time. [Short Term (1 year)]

Effective implementation of the National Strategy for Eye Care will require strategic oversight grounded in diverse expertise. The establishment of a Strategic Steering Committee within the proposed Vision Health Desk is recommended to ensure the Strategy's successful long-term execution and ongoing knowledge sharing and collaboration with provinces and territories. The composition of the Committee is a critical feature, bringing together stakeholders across the vision care continuum to ensure that strategic decisions are informed and reflect the needs of the low vision and blind community. This includes:

• People with lived experience to ensure the Strategy is anchored in the lived reality of living with low vision and blindness
• The vision health workforce including ophthalmologists, optometrists, opticians, orthoptists, vision rehabilitation and habilitation therapists, client care navigators, orientation and mobility specialists, low vision specialists, and others, to provide insight into service delivery challenges, clinical standards of care and interprofessional collaboration
• Researchers to ensure implementation efforts are guided by peer-reviewed evidence, clinical standards, and the latest population-health research
• Vision health leaders to provide a system-level perspective on barriers, opportunities, and alignment with existing emerging initiatives

02. Building Commitment: Establishing a Formal Vision Health Desk

We recommend that the federal government establish a Vision Health Desk to coordinate Canadian research investments, centralize data collection on vision health, drive public awareness campaigns and provide leadership and oversight for the implementation and accountability of the National Strategy for Eye Care. [Short Term (1 year)]

The National Strategy for Eye Care requires a dedicated hub to support a coordinated implementation and ensure accountability. Currently, the federal government lacks a centralized point for coordinating initiatives, monitoring progress, and driving a national agenda on vision health, leading to fragmented efforts and inconsistent data.

The creation of a Vision Health Desk is essential to provide the necessary stewardship and sustained leadership for the Strategy. This desk would fulfill a multifaceted mandate, including:

• Acting as a central body that provides leadership and oversight for the Strategy's implementation, including facilitation of interprovincial coordination, establishing key performance indicators, and issuing public reports on the progress, outcomes and resources allocated to the Strategy
• Serving as a national repository for vision health data and coordinating federal funding
• Leading the development of national awareness campaigns

To execute this broad mandate, the Vision Health Desk must be accompanied by a dedicated, multi-year funding commitment from the federal government, to ensure staffing of vision health experts and to sustain programs and initiatives. The Vision Health Desk ensures the long-term sustainability and effectiveness of the National Strategy for Eye Care.

03. Launching a National Public Awareness Campaign

We recommend that the federal government launch a national public awareness campaign focused on prevention, early detection, role clarity, and reducing stigma associated with vision loss, to empower Canadians to take proactive steps in protecting their eye health. [Short Term (1 year)]

A national public awareness campaign on common eye conditions and the impact of delayed detection should be a key focus of the National Strategy for Eye Care. It serves as a primary tool to address behavioural barriers and reduce the burden of preventable vision loss.

The need for a national awareness effort is clear: while 97% of Canadians consider eye health a crucial part of their overall well-being, one in three adults do not follow the Canadian Association of Optometrists eye exam guidelines, contributing to a significant gap in prevention and early detection interventions. This leads to increased occurrence of diagnosis at later disease stage which is costly and preventable.

A comprehensive, national campaign must aim to address three core objectives:

• Educate Canadians on proactive measures to protect eye health such as wearing sunglasses that block 100% of UVA and UVB light, seeking shade during peak sun hours, smoking cessation, managing screen time, and linking healthy diet to long-term vision protection.
• Effectively communicate the benefits and recommended frequency of regular eye examinations for prevention and early detection of eye diseases, including increased risk for those with diabetes or hypertension, and the importance of routine comprehensive eye exams for children prior to starting school.
• Enhance role clarity for Canadians regarding the roles of each member of the vision health workforce, including ophthalmologists, optometrists, opticians, orthoptists, vision rehabilitation and habilitation therapists, client care navigators, orientation and mobility specialists, low vision specialists, and others.
• Address the stigma associated with low vision and blindness by dispelling misconceptions, promoting the capabilities and contributions of individuals who have low vision or blindness, and encouraging inclusive practices in public and the workplace.

The campaign must be developed in collaboration with people with lived experience, the vision health workforce, and community-based organizations. Messaging must be available in Braille, large print, audio, digital accessibility formats, and translated into a wide range of languages including Indigenous languages.

04. Data: Understanding the Landscape of Eye Care Across Canada

We recommend that the federal government commission an independent, third-party audit to evaluate the uptake and utilization of federal public coverage programs and identify coverage gaps across the general population. [Medium Term (2-3 years)]

The federal government is responsible for the provision of essential vision health services and coverage to specific populations, including First Nations and Inuit under the Non-Insured Health Benefits (NIHB), individuals incarcerated in federal institutions through Correctional Services Canada (CSC), veterans through Veterans Affairs Canada, serving members of the Canadian Armed Forces, and immigrants and refugees through the Interim Federal Health Program (IFHP).

Currently there is an absence of publicly available utilization and uptake data for these programs. Without this information, it is not possible to evaluate whether benefit packages are effective or appropriate for the populations they are intended to support. This gap limits the ability to assess whether eligible individuals are accessing services or coverage and prevents monitoring and addressing disparities in care.

Recent studies show that certain populations covered under federal programs, such as Indigenous Canadians - particularly those living in rural and remote areas - experience a number of barriers to accessing vision health services. These include inadequate transportation, financial constraints, and a lack of on-reserve care. Significant coverage gaps also exist for those who fall outside of direct federal jurisdiction, and are of particular concern for children and seniors.

To address these complexities, the federal government must commission an independent, third-party audit to:

• Conduct a data-informed evaluation of the services and coverage currently available to federally covered populations, going beyond expenditures to identify systemic and practical barriers to participation.
• Perform a concurrent analysis of the general population to map out coverage deserts and better understand where more resources may be needed.

The resulting data will be essential for the development of targeted, evidence-based policy solutions that will meaningfully improve vision health outcomes and reduce health inequity in Canada.

05. Developing a National Data Infrastructure

We recommend that the federal government develop and implement national data infrastructure to collect and share vision health indicators that track prevalence, system performance and access to support evidence-based policy, planning, and equitable care delivery. [Short Term (1 year)]

Standardized data collection and reporting is essential to inform policies, care pathways, and best practices for vision care. Canada currently lacks high-quality data on screening and detection, uptake of preventative interventions, workforce metrics, wait times, access to treatments, post-treatment outcomes, and occurrence of vision loss. Robust interprovincial data sharing remains unattainable within the current fragmented system.

To ensure that future social support and health care resource allocation adequately reflects the clinical and social needs of the population, Canada must develop a robust and centralized database on vision prevention, detection, loss, treatment, and the vision health workforce. A standardized data reporting framework for vision health across provinces and territories must be incorporated, including clinically validated indicators developed in consultation with the full range of vision health professionals.

06. Dedicated Research Funding

We recommend that the federal government create dedicated research funding for the entire spectrum of vision health. [Medium Term (2-3 years)]

Canada is home to world-class vision health researchers who are driving systemic solutions and advancing innovations, yet their impact is limited due to the lack of dedicated funding. The majority of federal funding for vision health is currently administered through the Canadian Institutes of Health Research (CIHR) Institute of Neurosciences, Mental Health and Addiction (INMHA). This structure presents several challenges - much of vision health research is ophthalmic, public health, social, or technological in nature, not neuroscientific. Vision health research proposals must also compete with life-threatening neuroscience and mental health priorities, often leading applications to be overlooked.

The federal government must establish a dedicated vision health funding stream that provides consistent, long-term investments across the continuum of research - from discovery science and clinical applications to health systems and individual experience.

07. Working in Partnership with Indigenous Communities

We recommend that the federal government work in partnership with Indigenous communities to co-design equitable standards of care for programs and services related to vision health. [Medium Term (2-3 years)]

Vision health remains a critically underserved and overlooked area for Indigenous peoples in Canada, with preventable and treatable eye conditions occurring at disproportionately higher rates. Indigenous peoples must often travel long distances - up to 900 kilometers in territories - to see a vision health professional. While the federal NIHB program provides partial coverage, long processing times and the need to travel away from home often diminishes the program's effectiveness.

Access to basic vision care for Indigenous youth is particularly limited, with 32% living in remote regions where services are minimal, and rates of blindness being six times higher relative to non-Indigenous children. Over the last two decades, the percentage of Canada's Indigenous populations living with diabetes has risen by 20%, increasing the risk of diabetic retinopathy and other vision health complications.

The federal government must work in partnership with Indigenous communities to address these systemic barriers through culturally appropriate co-designed community-based standards of care, integrating mobile vision clinics, telemedicine services, and workforce training strategies.

08. Creating Coordinated Person-Centred Care Pathways

We recommend that the federal government work in collaboration with provincial and territorial governments, and key interest-holders to support coordinated, person-centered care pathways that span from prevention to rehabilitation and habilitation. Ensuring individuals receive the right care, at the right time, by the right professional, with clear pathways to navigate services, and consistent accountability across the vision health workforce. [Medium Term (2-3 years)]

The vision health system is often difficult or unfamiliar to navigate, creating significant distress and delays for patients, especially for those coping with a new diagnosis of vision loss. Unlike streamlined pathways for conditions like acute cardiac events, the patient journey through the vision health system is often marked by variability in triage, unclear referral processes, and limited guidance on next steps.

To resolve these challenges, coordinated, person-centred care pathways must be established that adhere to the No Wrong Door approach - ensuring that regardless of the entry point, individuals are connected to the right care at the right time.

The federal government must collaborate with provinces, territories, and key interest-holders to support:

• National clinical guidelines that establish consistent triage standards between primary health care professionals and the continuum of the vision health workforce.
• Dedicated Vision Health Navigators who provide personalized, non-clinical support to guide individuals through the system, help coordinate referrals, and connect patients to social and mental health supports.
• Secure digital infrastructure that enables tracking and communication across the continuum of patient care.

09. Expanding Education and Training

We recommend that the federal government work in collaboration with provincial and territorial governments, and key interest-holders to expand education and training for primary health care professionals (non-vision) to strengthen their capacity in prevention, early detection, and referral to appropriate vision care services. [Medium Term (2-3 years)]

For many Canadians, particularly in rural and remote regions, primary health care professionals are the first, and often only, point of contact with the health care system. Currently, primary health care professionals (non-vision) receive limited formal training in vision care. Vision health is often siloed from other health services despite its role as a critical determinant of overall health and well-being, and its strong connection to chronic disease, prevention management, and aging.

Federal and provincial governments must work collaboratively with primary health care (non-vision) education institutions - including medical schools, nursing programs, and allied health training programs - to expand education and training on vision health. Strengthening knowledge and competencies in prevention, early detection, and appropriate referrals will enable earlier interventions, ultimately reducing overall health system costs and improving population well-being.

10. Equitable and Consistent Pan-Canadian Access

We recommend that the federal government convene provincial and territorial governments, along with key interest-holders, to collaboratively develop equitable and consistent pan-Canadian access to and quality of vision health services, rehabilitation, habilitation, and medical devices. [Ongoing]

Access to vision health services varies significantly across the country, creating a patchwork of care where Canadians' postal codes often dictate their health outcomes. Most routine eye exams and prescription glasses are not covered by public health insurance, with the exception of children and seniors and medically necessary exams. Out-of-pocket costs are high and often unaffordable for Canadians in lower income brackets.

Without timely detection and intervention, many conditions can silently progress, increasing the risk of vision loss and associated health complications such as falls, depression, and reduced quality of life. Given Canada's growing and aging population, costs are anticipated to reach $56 billion by 2050 - 1.7 times greater than 2019 costs.

The federal government must convene provinces, territories and interest-holders to encourage the collaborative development of equitable and consistent pan-Canadian access to and quality of vision health services, rehabilitation, habilitation, and medical devices.

11. Looking Ahead: Ongoing Monitoring and Evaluation

We recommend that the federal government work in collaboration with provincial and territorial governments, and key interest-holders to evaluate and monitor current and future vision health workforce requirements and to develop targeted strategies that strengthen and sustain the workforce across the continuum of care. [Medium Term (2-3 years)]

Canada is currently facing significant challenges in meeting the growing demand for vision health care. A shortage across the vision health workforce is exacerbating wait times and limiting access to essential services, most acutely in rural, remote, and Indigenous communities. As Canada's population ages, the prevalence of eye disease is expected to rise, placing further pressure on an already strained system.

The federal government must act as a convener to harmonize data collection and workforce evaluation and monitoring across provinces and territories, driving targeted initiatives such as incentives for the vision health workforce to practice in underserved communities and expanded training programs.

12. Regulatory Processes and Drugs, Medical Devices

We recommend that the federal government identify pathways to streamline the regulatory review process for drugs and medical devices, while maintaining rigorous standards for safety and efficacy. [Medium Term (2-3 years)]

Stakeholders across the vision health sector frequently highlight that Canada's current regulatory process is complex, lengthy, and often duplicative compared to international peer countries. This results in delays of months or even years for Canadian patients to access new, innovative therapies and devices, and disincentivizes submissions from manufacturers.

The federal government must identify specific solutions that enhance regulatory review system efficiency while upholding safety and quality standards, to ensure Canadians benefit from the latest innovations in vision health.

13. Establishing Vision as a National Priority

We recommend that recommend that the federal government convene provincial and territorial governments, and key interest-holders to emphasize vision health as a consistent national priority within primary care frameworks and chronic and acute care pathways, while maintaining clear accountabilities. [Ongoing]

Vision health is often siloed and treated as separate from overall health, rather than integrated into primary care and chronic disease management. This fragmentation particularly impacts individuals with chronic diseases such as diabetes and hypertension, who are at significantly increased risk of developing vision-threatening conditions. It also affects individuals who experience vision loss related to other health events, such as stroke.

The federal government must convene provinces, territories, and key interest-holders to emphasize the importance of consistently integrating vision health within primary care, chronic disease, and acute care pathways. Effective integration includes strengthening awareness of established vision care pathways, ensuring vision-related changes are appropriately recognized and referred, and supporting shared electronic health records that facilitate exchange of relevant vision health information.

14. Equitable Access to Assistive Technology

We recommend that the federal government convene provincial and territorial governments, and key interest-holders to develop equitable and consistent pan-Canadian access to and quality of assistive technology programs. [Medium Term (2-3 years)]

Assistive technologies - ranging from electronic magnifiers, CCTVs, and braille displays to specialized wearable devices and software - are essential tools that enable individuals with vision loss to perform daily tasks, access information, and navigate environments. Access to these technologies largely depends on where an individual lives in Canada, resulting in significant inequities.

Most provincial frameworks also strictly exclude mainstream technologies from being classified as "assistive," despite these devices now functioning as powerful accessibility tools. This leaves individuals paying entirely out-of-pocket for essential technology.

Through a collaborative partnership, the federal government must convene provinces and territories to establish equitable and consistent pan-Canadian access to and quality of assistive technology programs.

15. Commitment to Ongoing Investment

We recommend that the federal government develop and implement federal funding streams to expand equitable and timely access to vision health services, including rehabilitation and habilitation services, medical devices and assistive technologies for underserved and marginalized populations across Canada. [Ongoing]

Only 43% of Canadians report having vision care insurance, while 24% skipped their eye exam because it was not covered by insurance. Gaps in insurance coverage for vision rehabilitation services contribute to disparities in care for the estimated 2.2 million Canadians living with some form of vision impairment.

By directly addressing these disparities through targeted federal funding, Canada can achieve long-term cost savings by enabling people to access routine eye care, medical devices and assistive technologies early - reducing reliance on costly interventions for advanced disease.

16. Strengthening Disability Support Programs

We recommend that the federal government strengthen disability support programs by integrating education, high skilled training and employment pathways for individuals with low vision and blindness. [Medium Term (2-3 years)]

The diagnosis of vision loss is a life-altering moment that fundamentally changes an individual's way of life, self-identity, and economic security. Individuals living with vision loss face fewer job opportunities, increased absenteeism, and reduced productivity. Reduced employment is estimated to contribute $3.2 billion to overall productivity loss, while reduced productivity while at work accounts for $381 million and increased absenteeism for $319 million.

Dedicated federal funding for vocational rehabilitation is essential, including ongoing specialized training in assistive technologies such as screen readers, tactile displays, and adaptive software, and tailored job matching and coaching.

17. Looking Ahead: Establishing Readiness

We recommend that the federal government work in collaboration with provincial and territorial governments, and key interest-holders to ensure there is advanced planning and inclusion of specific, accessible protocols for individuals with low vision and blindness in national and regional emergency preparedness, response, and recovery plans. [Medium Term (2-3 years)]

Individuals with low vision and blindness are disproportionately vulnerable during climate-related disasters and health emergencies due to systemic barriers in communication, evacuation, and continuity of care. Emergency planning is often designed for the general population, resulting in a dangerous gap for those who rely on non-visual information and specialized support systems.

The COVID-19 pandemic further highlighted these gaps, with many employees who worked from home discovering they lacked necessary accessible technology, and with employers often refusing to fund essential accommodations.

To address these risks, the federal government must lead the development of inclusive national guidance for emergency management, including mandating accessible alert formats and classifying essential vision treatments as critical services that must continue during health emergencies. These plans must be co-designed with people with lived experience.