Why have amounts for vision care coverage essentially remained stagnant for 20 years? Dr. Alan Ulsifer, Chair and CEO of FYidoctors, explained why this needs to change in a recent podcast produced by Benefits Alliance Voice. FYidoctors is an eye care provider with more than 400 optometrist-owned clinics across Canada.
Vision care is one of the most cost-effective employee benefits available. Versant Health (USA) reports that premium vision benefits can yield a 15:1 return on investment through improved productivity and reduced medical costs. Yet, Canada is missing this opportunity. The 2024 Vision Council’s Consumer inSights Canada data revealed that Canada lags behind the U.S. and European countries, with only 45 per cent of Canadians having vision care benefits, 53 per cent through employer plans and 25 per cent through government programs.
Amidst rising costs for eyeglasses and lenses, Canadians have expressed dissatisfaction with their current coverage. When surveyed in 2021, 2024 and 2025 by the Benefits Canada Healthcare Survey, plan members consistently stated they would like more coverage for vision care (ranked second after dental care). However, since not all employees require corrective eyewear, employers often struggle with the cost-benefit analysis of universal vision care coverage.
Beyond eyesight
Ulsifer emphasized that vision care today is much more than a basic exam for eyesight. New technology enables comprehensive exams that detect early stages of chronic diseases, such as diabetes and high blood pressure.
As Ulsifer explained, the eye provides unique diagnostic opportunities. “It’s the only place where you can visibly see blood vessels and nerve fibre without doing a biopsy, or scans, or anything else.”
Early detection is a win-win for both employees and employers. Employees experience better quality of life while employers see reduced absenteeism, presenteeism, medical costs and disability claims.
As well, 75 per cent of vision loss is preventable if caught early. Yet many Canadians remain unaware, leading to high-risk gaps in care. “One in four Canadians who don’t wear eyeglasses have not had an eye exam in about 10 years,” Ulsifer said. He added that 16 per cent of Canadians didn’t have their first eye exam until after the age of 31.
What’s scary is that the symptoms for some eye diseases that can cause blindness, such as glaucoma, may go undetected until it’s too late. “When you start having symptoms with glaucoma, we can slow it a bit, but you’re going to have major, major issues,” Ulsifer said. Another cause for blindness, which may go undetected without an eye exam, is retinal detachment. Problems usually start at the periphery of the retina, so people may not be aware of deteriorating peripheral vision. And there are no pain receptors in the retina to give warning.
“Don’t assume that a painless eye is a healthy eye, and don’t assume that your vision is good,” Ulsifer cautioned, adding that the loss of visual acuity happens gradually. “I can’t tell you how many times I’ve shown people what they would see with lenses and without, and they just can’t believe it.”
Long periods of screen time for work, studies, and entertainment also impact eye health. Today, 35 to 45 per cent of people have dry eye problems, according to Ulsifer, which is strongly linked to prolonged screen time. For children, prolonged screen time is leading to a dramatic rise in myopia. Fortunately, there are preventative measures and treatments for both conditions, but first people need to be seen by an optometrist to diagnose the problem.
Importantly, people with vision coverage get their eyes checked more often, Ulsifer said.
New perspective
Transforming vision care depends on education and clear communication, suggested Ulsifer. Employees need to understand that comprehensive eye exams extend beyond eyesight to the monitoring of overall health, while employers need data demonstrating tangible benefits. Insurance companies and optometrists can work together to provide this data and clearly demonstrate positive outcomes.
The U.S. model of stand-alone vision insurance companies provides a roadmap for outcomes-based coverage, noted Ulsifer. By treating vision care as preventive health care rather than just a workplace perk, Canadian employers can address a wide range of vison and health issues—including the early detection of chronic diseases—that promise to achieve returns that far exceed their investments.