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Ministry of Health and Long-Term Care (Ontario Health Insurance Plan)

Date: 2013

The Ombudsman received four complaints in 2011 about the lack of funding for a relatively new eye surgery known as “CXL” – Corneal Collagen Cross Linking – which involves a riboflavin solution treatment for keratoconus, a condition that causes thinning of the cornea and vision loss.

All four complainants had been recommended for the treatment by medical professionals, but it was not covered by OHIP. They had all been told that their condition was worsening and they would eventually need a corneal transplant – once they reached the point of vision loss. By contrast, their specialist recommended CXL treatment as a way to improve their vision and stop progression of the disease – but it would cost up to $4,000.

Officials at the Ministry of Health and Long-Term Care told Ombudsman staff that they were discussing CXL treatment with the Ontario Medical Association and had received numerous inquiries from the public. The Ministry conducted an evidence-based review of the procedure to determine whether it should be covered by OHIP.

In early 2013, the Ministry launched a three-year pilot project to provide funding for CXL treatment through the Kensington Eye Institute. The Ministry will review the success of the procedure to determine whether or not patients subsequently still require corneal transplants. Once the data from the pilot project is reviewed, the Ministry will then determine whether CXL should be permanently added to the schedule of OHIP benefits.

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