Hon. Mohamed-Iqbal Ravalia moved second reading of Bill C-284, An Act to establish a national strategy for eye care.

He said: Honourable senators, it is my pleasure today to speak to you as the sponsor of Bill C-284, An Act to establish a national strategy for eye care, and designate an age-related macular degeneration awareness month.

Our vision allows us to experience the beauty of our world, to connect with others and to navigate the complexities of daily life. However, for too many Canadians, vision care is a luxury. Access to essential vision care services remains a challenge, and it’s one that we must address with both urgency and compassion.

Advances in technology and virtual care have opened pathways in this regard. Vision care is an integral part of a comprehensive health care system, and we should make it a priority to ensure that high-quality vision care is accessible for all.

In my clinical practice, I have witnessed the tragic sequelae of preventable ocular diseases in many instances purely on the basis of a lack of access or affordability. Vision impairment, whether through experiencing visual challenges or requiring assistance such as glasses, contacts or other aids, has touched the lives of virtually everyone either directly or through loved ones.

Before I begin, I want to express my gratitude to MP Judy Sgro, who has championed the efforts towards a strategy for vision care in the other place and has been a national advocate for people with age-related macular degeneration and various vision health issues.

I also applaud the careful thought and consideration of my members on the Standing Committee on Health in the other place. This past spring, members carefully studied this bill and helped maintain the federal and provincial jurisdictional limits on health care, professional training and guidelines. This bill passed with resounding unanimity, underscoring the collective recognition of the importance of vision care in our society.

We are presented with a unique opportunity to champion a cause that touches the lives of individuals, families and communities across our country.

The vision loss crisis in Canada requires a coordinated response, and this is what the national eye care strategy is all about. Over 8 million Canadians — or one in five — have an eye disease. There are 1.2 million Canadians who live with vision loss or blindness. There were over 1,200 deaths associated with vision loss in 2019 alone.

Meanwhile, 75% of vision loss cases can be prevented if patients are diagnosed early and have access to treatment.

Colleagues, the need for a national strategy is necessary to address the gaps and inconsistencies in access and delivery of vision care across the country. As we know, with our 10 provinces and 3 territories, it can feel like we sometimes have 13 separate health care silos or that we’re living in 13 fiefdoms.

Basic eye examinations are not universally covered under provincial health care plans. Some provinces provide coverage for specific groups such as children, seniors or individuals with certain medical conditions. Many Canadians rely on private insurance plans to cover the costs of routine eye exams, glasses and contact lenses. But even with private insurance, there might still be out-of-pocket expenses for vision care, especially for individuals who have no coverage. The cost of eyeglasses, contact lenses and certain eye treatments can be a significant barrier for Canadians accessing the necessary care.

Accessibility also depends on where you live, with urban areas generally having better access to eye care facilities than rural or remote ones. Practically speaking, this can impact the ability of individuals to access preventative care and may contribute to delayed diagnosis and treatment of eye conditions. By detecting these early, the health care system can avoid the costs associated with advanced treatments and complications.

The challenges associated with the delivery of vision care services have been exacerbated by COVID with many Canadians missing regular eye appointments, surgeries and other treatment plans, increasing the risk of more complications.

Vision loss has a profound impact on individuals, their families and society, costing our economy an estimated $32.9 billion a year. Of this cost, $4.2 billion is attributed to reduced productivity in the workplace. Over half the cost — $17.4 billion — is attributed to the reduced quality of life, which is primarily due to a loss of independence, especially in our aging demographic. Over $983 million was spent last year across Canada on injections to treat macular degeneration.

Losing one’s vision increases mental, financial and social hardship. It can lead to a loss of mobility, an inability to live independently, to drive, to read or to participate in physical activity. It can result in the loss of social interaction, which can often lead to loneliness, isolation and the mental sequelae thereof. A national strategy can promote cost-effective and efficient use of health care resources and dollars to help combat vision loss across the country.

The bill before us today is straightforward. It calls for the Minister of Health in consultation with representatives of provincial governments responsible for health, Indigenous groups and other relevant stakeholders, including health care researchers and practitioners, to develop a national strategy to support the prevention and treatment of eye disease as well as the vision rehabilitation plan to ensure better health care outcomes for all.

It outlines the strategy that encompasses preventive care, early detection, treatment and accessibility. The strategy would aim to raise awareness of the impact of vision loss and blindness, improve eye health care and support and foster innovative research to advance new therapies for vision loss and rehabilitation. The bill is also calling on enhanced access to eye health care for Indigenous people.

While there are benchmarks, including timelines, by design, it is not overly prescriptive in what the strategy should entail. The government must be allowed the flexibility to respect the consultative process of this legislation. This legislation would ensure a coordinated national strategy aimed at ensuring Canadians have access to vision care regardless of where they live.

It also recognizes Canadians’ experiences and struggles with age-related macular designation through a designation of February as age-related macular degeneration awareness month.

Age-related macular degeneration is a condition that affects many Canadians over the age of 55 and is the leading cause of blindness among these Canadians. I know that many of us are in this demographic.

This condition affects the central vision, which is the most important part of an individual’s eyesight. It is a progressive condition that leads to vision loss and may increase the risks of other health concerns such as anxiety, depression and progression to dementia.

As our population ages, we must be vigilant in promoting awareness around age-related macular degeneration, increasing accessibility to currently available treatments and supporting the necessary research for developing new treatments needed by many Canadians across our provinces and territories.

We have the opportunity to be one of the global leaders in the delivery of vision care. We can draw from strong examples in other nations for service delivery and accessibility in vision care. While we know that there is no one-size-fits-all model for the delivery of care across different countries, the strategy will examine existing strategies, frameworks and best practices, as well as lessons learned from other jurisdictions.

Honourable colleagues, a national strategy would address the wide inconsistencies in access to care; work to prevent and slow the progression of vision loss, where possible; help us tailor services to the needs of all Canadians in a culturally appropriate manner; and allow us to foster research and innovation to better inform policy-makers on this issue.

This bill is important to millions of Canadians and is long overdue. Let us acknowledge the tireless effort of health care professionals, advocacy groups and individuals who have championed this cause and called for federal leadership. Their commitment to the well-being of Canadians deserves our utmost respect and support.

Making eye health and vision care a health priority requires all of our support. Colleagues, we can work together to ensure that 1.5 million Canadians with sight loss are provided with the necessary supports and the opportunity to live productive, healthy lives. Meegwetch. Thank you.