When Does OHIP Cover Eyelid Surgery?
OHIP covers upper eyelid surgery when excess skin causes a documented functional impairment — specifically, obstruction of the superior visual field that affects daily activities such as driving, reading, or walking safely. This is not based on appearance alone: it requires objective testing.
The key instrument is Humphrey visual field perimetry — a standardised test that maps your peripheral vision and demonstrates, in measurable terms, how much of your visual field is obscured by the overhanging eyelid skin. OHIP requires a specific degree of documented obstruction before approving coverage.
At EyeFACE, OHIP assessment is a routine part of our upper eyelid consultation. Many patients are surprised to discover they qualify — particularly those who have assumed their hooding is purely a cosmetic concern.
OHIP-Eligible Conditions
Dermatochalasis with visual field obstruction
Excess upper eyelid skin that overhangs the lash margin and obstructs the superior visual field on Humphrey testing. The most common OHIP-eligible presentation.
Ptosis (eyelid drooping)
Drooping of the upper eyelid margin — distinct from skin excess — caused by weakening of the levator muscle. When the margin obstructs the visual axis or produces significant visual field loss, ptosis repair is covered by OHIP.
Brow ptosis contributing to visual field loss
Descended brow that compounds upper eyelid hooding. When documented on visual field testing, brow ptosis may contribute to OHIP eligibility.
Ectropion and entropion
Outward (ectropion) or inward (entropion) turning of the eyelid margin that causes corneal exposure, chronic tearing, or surface damage. Correction is typically covered by OHIP.
The OHIP Process — Step by Step
Clinical Assessment
Dr. Gill examines your upper eyelids, photographs the hooding, and assesses whether your anatomy meets the clinical criteria for visual field obstruction.
Humphrey Visual Field Testing
Standardised perimetry testing maps your peripheral vision with eyelids in their natural position. The test documents exactly how much visual field is obstructed by the overhanging skin.
OHIP Submission
Dr. Gill submits the clinical assessment, photographs, and visual field results to OHIP. Our team manages the paperwork entirely — you do not need to navigate this process yourself.
Approval & Scheduling
Once OHIP approval is received, the procedure is scheduled at our CPSO Level 3 facility. Surgical and anaesthesia fees are billed directly to OHIP.
Why an Oculofacial Surgeon for OHIP Work?
OHIP-covered eyelid surgery requires more than surgical skill — it requires the clinical training to distinguish ptosis from dermatochalasis, to recognise concurrent eyelid malposition, to arrange and interpret visual field testing, and to navigate the OHIP documentation and approval process. These are core competencies of oculofacial practice — not add-ons to a cosmetic portfolio.
Most general plastic surgeons and facial plastic surgeons do not perform OHIP eyelid work. At EyeFACE, it is a significant part of our practice — and the experience of managing hundreds of OHIP cases informs the precision of our cosmetic work as well.
What the Consultation Includes
- ✓Clinical assessment of your upper eyelid anatomy and function
- ✓Review of your symptoms and daily functional limitations
- ✓OHIP eligibility assessment — at no additional charge
- ✓Humphrey visual field testing arranged if clinically indicated
- ✓A clear explanation of whether OHIP will likely cover your case
- ✓Personalised surgical plan and timeline
Consultation fee: $450, applied to your procedure.
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