Why these conditions change how we examine your eyes
When you tell us you have diabetes or high blood pressure, we approach your exam differently. Both conditions damage blood vessels — and the retina is where we can see that damage directly, often before it causes any symptoms or is detected anywhere else in the body.
This is not a routine screening checkbox. It is one of the most clinically valuable parts of what we do.
What your exam includes at Spadina Optometry
For patients with diabetes or hypertension, every exam includes:
- Retinal photography — high-resolution images of your retina and optic nerve that we store and compare visit to visit. Subtle changes between visits are often the earliest sign that something is progressing.
- OCT (optical coherence tomography) — cross-sectional scans that measure the thickness of your retinal layers. This is how we detect diabetic macular edema — swelling that threatens central vision — before you notice any change.
- Dilated fundus examination — a direct view of the peripheral retina, where some diabetic changes first appear and where routine photos may not reach.
- Blood vessel assessment — we evaluate the condition of retinal arteries and veins for signs of damage from high blood sugar or high blood pressure.
OHIP covers the base exam for qualifying patients. The imaging is beyond what OHIP funds and involves a supplemental fee, which we explain before we proceed. This imaging is part of our standard of care for these conditions because it materially changes what we can detect and how early we can catch it.
How we set your recall schedule
We do not use a one-size-fits-all interval. Your recall is based on what we find:
- Diabetes, no retinopathy detected: annual exam
- Mild to moderate retinopathy: every six to twelve months, depending on severity and whether changes are stable or progressing
- Severe or proliferative retinopathy: every three to six months, with referral to a retinal specialist
- Hypertension, no retinal changes: annual exam
- Hypertensive retinal changes detected: more frequent visits, coordinated with your family doctor
If your blood sugar control or blood pressure management changes significantly between visits, let us know — we may bring your next appointment forward.
How we work with your care team
When we find retinal changes related to diabetes or high blood pressure, we send a report to your family doctor or endocrinologist. This is not a generic letter — it includes our imaging findings and clinical assessment so your care team has specific, actionable information about what is happening in your eyes.
Your eye exam becomes part of your overall disease management, not a separate silo.
If you do not have a family doctor, we can still monitor your eye health and refer to community resources. Toronto has over 30 Community Health Centres that provide primary care on a sliding scale — find one at allianceon.org. You can also reach Telehealth Ontario at 1-866-797-0000 for 24/7 health advice.
OHIP coverage at Spadina Optometry
Diabetes: Adults aged 20 to 64 with diabetes qualify for OHIP-covered eye exams. We bill OHIP directly. The supplemental imaging fee is explained upfront and may be covered by your private insurance.
Hypertension: Not a listed qualifying condition on its own for adults 20 to 64. But if we find retinal disease — which hypertensive retinopathy can be — that finding may qualify you. We handle this determination and the billing.
Children and seniors: OHIP covers exams for all children under 20 (annually) and adults 65+ (every 18 months) regardless of medical conditions.
If you have both OHIP eligibility and private insurance, they can work together — OHIP covers the base exam and your private plan may cover the supplemental imaging.
For full coverage details, see our OHIP eligibility page.
Do not wait for your benefits to reset
For patients without risk factors, timing an exam around a benefits cycle is fine. For patients with diabetes or high blood pressure, it is not.
Diabetic retinopathy can progress from treatable to sight-threatening in under a year. Hypertensive retinal damage correlates with damage happening elsewhere in your body. When we set a recall interval, it is based on the rate at which these conditions can change — not your plan's reimbursement schedule.
If your insurance covers exams every 24 months but we recommend annual monitoring, the gap year is the one that matters most.
Related
Have diabetes or high blood pressure?
Let us know when you book so we can allocate the right amount of time for your visit. No referral needed.
Prefer to talk first? Call or text us at 416-703-2797.
Last reviewed: March 28, 2026