More Than Half of Quebec Optometry Clinics Decline Emergency Appointments for New Patients

Wednesday, May 14 2025 | 11 h 48 min | News

A recent study has revealed that over half of optometry clinics in Quebec do not offer emergency appointments to individuals who are not already established patients at their clinic. The research, led by Dr. Benoît Tousignant of the Université de Montréal in collaboration with optometry students Catherine Binette and Ariane Duchesne, sheds light on access challenges faced by patients without a regular eye care provider.

Published in Clinical and Experimental Optometry, the study used a simulated-patient method to assess real-world access to emergency eye care. Between May and June 2022, the two students called 95 optometry clinics across Quebec from Tuesday to Thursday, presenting themselves as new patients with urgent ocular symptoms: either a red eye (suggestive of conjunctivitis) or the sudden onset of flashes and floaters (potential signs of a retinal tear).

The result: 53.9% of clinics did not offer an appointment.

The researchers chose the simulated-call approach to avoid response bias and better reflect how an average patient might experience the healthcare system when seeking urgent care.

Regional Disparities in Access

The study revealed notable differences based on location. Clinics in rural areas were significantly more likely to offer emergency appointments (68.9%) compared to those in urban (40%) or peri-urban (30%) settings. One possible explanation is that rural optometrists may take on a broader scope of care due to limited access to specialized hospital services nearby.

Slight Preference for Simpler Cases

Clinics were marginally more likely to accept red eye cases (34.8%) than potential retinal emergencies (30.3%). The authors suggest this may be due to the complexity of care required. While conjunctivitis can often be assessed quickly, symptoms like flashes and floaters usually demand pupil dilation, extended examination time, and possible referral.

When Appointments Were Offered, Care Was Prompt and Affordable

For patients who did receive appointments, the average wait time was just 3.7 hours. More urgent scenarios (flashes and floaters) were seen slightly faster (3 hours) than milder ones (4.9 hours). Out-of-pocket costs were fairly consistent across the province, with an average fee of approximately $55.

More About Distribution Than Capacity

The study does not question the competency or capacity of optometrists in Quebec—who collectively manage over 185,000 urgent eye cases annually—but rather points to uneven distribution of that care. Some clinics appear to absorb a large share of emergency visits, while others take on few or none.

Dr. Tousignant emphasizes that future research should aim to better understand what enables certain clinics to integrate urgent visits more effectively. Identifying those operational factors could help inform broader strategies to improve emergency eye care access for all patients.

Reference:
Tousignant B, Binette C, Duchesne A. Accessing emergency eye care by therapeutically qualified optometrists: A simulated-patient study in Quebec, Canada. Clinical and Experimental Optometry. Published April 21, 2025.

Source: Université de Montréal

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