Prevention of Sexual Abuse

In accordance with the College of Optometrists’ zero tolerance approach toward sexual abuse of patients and the requirements of the legislation, the College has a Patient Relations Program that comprises measures for preventing or dealing with the sexual abuse of patients by optometrists, including:

  • educational requirements for members;
  • guidelines for the conduct of members with their patients;
  • training for the College’s staff; and
  • the provision of information to the public.

Section 85.7 of the Health Professions Procedural Code requires that every regulated health College also have a Program of Funding for Therapy and Counselling. This funding program is administered by the Patient Relations Committee. It is intended to compensate the cost of therapy and counselling for anyone who alleges he or she was sexually abused by a member of the College, while being a patient.

The College recognizes that a proactive Patient Relations Program, developed to enhance relations between members and patients, has the potential to improve patient care and reduce confrontations. In September 2013, College Council approved a revised Partnership in Vision Care document that articulates the collaborative nature of the relationship between optometrists and their patients. This collaboration is necessary to achieve and maintain optimum vision health.

Educational Requirements

The educational requirements for members are focused on four broad areas:

  • appropriate behaviours and interactions with patients, including avoidance of boundary violations;
  • recognition of and appropriate response to sexual abuse by other healthcare practitioners;
  • understanding the nature of sexual abuse and its impact on the patient;
  • understanding the legislative requirements of the Health Professions Procedural Code at s. 84 through s.85.7 (13).

The College has determined that all current members of at the College of Optometrists of Ontario, students currently in the optometry program at the University of Waterloo, and applicants for a Certificate of Registration to practise optometry in Ontario should receive education about these issues.

In the fall of 2017, all members of the College of Optometrist had to complete, as part of their annual renewal process, an e-learning module entitled “Professionalism, Ethical Decision-Making and the Prevention of Sexual Abuse of Patients.” This educational tool was aimed at helping optometrists understand what constitutes a professional boundary crossing or violation, what constitutes sexual abuse of patients and how unintentional boundary crossings could escalate.

Guidelines for Member Conduct

Patients are entitled to receive optometric care free from sexually abusive behaviours. Practitioners must endeavour to care for their patients in an environment of trust and respect. The College has published an advisory for members regarding how to behave with patients. Members are encouraged to review this advisory periodically and compare their behaviours to the guidelines set out in the advisory. The College has also published materials describing its position on the Spousal Exemption Regulation, introduced in 2020, which allows for optometrists to treat their spouses without its automatically constituting sexual abuse.

Training for College Staff and Council

The staff of the College of Optometrists of Ontario plays an important role in facilitating communication and resolution of patient/optometrist disputes and complaints. College staff and committee members may have the opportunity to support victims of sexual abuse through the reports, complaints, and disciplinary processes of the College. The College regularly provides training to its staff, Council, and committee members to ensure that those entrusted with this role are able to provide support and facilitate communication.

Communication and the Optometrist/Patient Relationship

During the 2009/2010 Council year, the Patient Relations Committee began expanding on existing and developing new materials to assist optometrists in meeting their patients’ needs. In addition to the creation of the Partnership in Vision Care, due to expanding cultural diversity of the population in Ontario, the Committee worked on a cultural competency component for the website. 

Provision of Information

Individual members of the public may not be aware of what behaviours differentiate normal optometric care from sexually abusive behaviour by an optometrist. The following information, which is provided to assist optometrists, is also intended to assist members of the public in identifying questionable requests or behaviours. Implicit in the provision of this information is the patient’s right to bring any questionable behaviour by their optometrist to the attention of the College.

It is important that patients are aware that optometrists are advised that:

  • having a patient disrobe during an optometric examination is never appropriate;
  • hugging and kissing is inappropriate and should never be initiated by the optometrist and respectfully declined if initiated by the patient;
  • touching should only be used as necessary to facilitate the optometric examination;
  • physical assistance may be required to facilitate patient positioning and manipulation of the head, eyelid or brow during an ocular examination;
  • patients in a reclined position during an examination may feel vulnerable and the reason for reclining the patient should be explained;
  • patients who are upset or nervous should be comforted with words rather than with touch;
  • appropriate touching, such as shaking hands or assisting in the transfer of patients (for example from a wheel chair to examination chair), may enhance the comfort of a patient;
  • before conducting a test that necessitates physical closeness, such as direct ophthalmoscopy (a test which involves the patient and optometrist sitting face to face) the test and how it is conducted should be explained to the patient;
  • questions and conversations must not have any references to sexual practices, thoughts, and orientation except where necessary, as in cases of diagnosis and treatment of ocular manifestations of sexually transmitted disease;
  • they should not comment on a patient’s appearance, clothing, or body unless clinically necessary;
  • they should not tell jokes or stories of a sexual nature;
  • they should not display material within the office that is sexually suggestive, or may be offensive to patients or staff; and
  • they should ensure that a member of the office staff or a third party is in attendance when services are performed within the optometry office outside of normal office hours.

If a patient initiates sexually inappropriate conversation or behaviour, this should be respectfully discouraged and a record of the incident made. Having a staff member or third party in attendance throughout the examination may help prevent any misunderstanding or accusation. If the patient persists in the inappropriate behaviour, the optometrist should end the optometrist/patient relationship by dismissing the patient.

Sexual activity between an optometrist and a patient, even if perceived as consensual by those involved, is by definition considered to be sexual abuse of the patient.

Definition of Patient in Regards to Sexual Abuse

The word “patient,” as it relates to the Code’s sexual abuse provisions, has been expanded; a former patient will remain a “patient” for one year from when the person would otherwise cease to be considered a patient (i.e., when the optometrist last provided care to the patient).

The Regulation under the RHPA establishes other criteria for defining a patient for such purposes. Without restricting the ordinary meaning of the word “patient,” an individual is a patient if there is a direct relationship/interaction between the individual and the optometrist and the optometrist has:

  • issued billings or received health payments for a health care service; or
  • contributed to a patient record/file for that individual; or
  • received consent from the individual for health care services recommended by the optometrist; or
  • prescribed a drug for which a prescription is needed, to that individual.

If any of the above interactions occur between an individual and an optometrist, then that individual is considered the optometrist’s patient, for the purposes of sexual abuse provisions. That individual will also continue to be considered a patient for one year after the termination of the optometrist/patient relationship. Any sexual act that occurs during that time between the optometrist and the individual would result in the optometrist being subject to mandatory revocation. Note that an individual is not a patient under these criteria when:

  • emergency care is provided to a preexisting sexual partner; and
  • there is no reasonable opportunity to transfer care to another health care professional.

Because of the broad definition of sexual abuse in the RHPA, a social relationship with a current or former patient may be considered sexual abuse. There are different types of social engagements that may be considered “dating.” However, sexual abuse occurs whenever a relationship with a patient involves behaviour or remarks of a sexual nature.

Program to Provide Funding for Therapy and Counselling

The legislation requires that all regulatory health Colleges have a program in place to provide funding for therapy and counselling for individuals who are alleging sexual abuse while they were patients of a regulated health professional. The College of Optometrists has established a segregated fund for this purpose and application forms are available for individuals who wish to request funding for therapy. Applications for funding are considered by the Patient Relations Committee.

Eligibility for Funding

An individual is eligible for funding if:

  • it is alleged, in a complaint or report, that the individual, while a patient of a current or former member of the College of Optometrists of Ontario, was sexually abused by the optometrist; and
  • the date of the alleged abuse must be on or after January 1, 1994.

The staff member responsible shall provide the necessary information to the Patient Relations Committee in order for the Committee to determine eligibility and to administer the fund. Payment will be made only to the therapist or counsellor chosen by the individual.

The Chair of the Patient Relations Committee informs Council of the status of the Fund on an annual basis.

Related FAQs

  • In order for a person to be eligible for funding there must be an allegation made, in a complaint or report, that the person was sexually abused by a current or former optometrist while the person was a patient of the optometrist or within one year after the individual ceased to be the optometrist’s patient.

  • Applications for funding are considered by the PRC, made up of four optometrists and four members of the public. The PRC reviews each application and determines:

    a) whether the applicant meets the eligibility criteria, and
    b) the amount of funding that is to be awarded for therapy and counselling.

    This funding is then paid directly to the therapist or counsellor for the therapy and counselling
    they provide.

  • No. Recent changes to the Regulated Health Professions Act, 1991 provide that funding will become available for patients alleging sexual abuse by an optometrist, even before any finding of guilt may be made against the optometrist. These changes are in effect as of May 1, 2018.

  • Under some conditions, the College may assist in paying for past therapy. To qualify, past therapy must not have been paid by any provider (OHIP or private insurance); the therapy must have taken place after the reported abuse; and the applicant or therapist must provide invoices or receipts with therapy costs and dates. The Regulated Health Professions Act requires that funds be paid directly to the therapist. The therapist must, therefore, agree to reimburse the applicant in return for funds paid directly to him/her for past therapy costs.

  • You need to complete an application form (Application for Funding for Therapy and Counselling). This form provides the PRC with the information they need to assess your eligibility. Additionally, you will have to attest that you have no family ties to the therapist or counsellor chosen and that the services provided to you are not eligible for payment by any other provider, such as OHIP or private insurance (Attestation of Applicant).

    You do not need to have a therapist or counsellor identified to apply for funding. If you have a therapist or counsellor or know who you would like to see, additional attestation will have to be signed by the therapist or counsellor. Please note that if you have chosen an unregulated health professional to be your therapist or counsellor, a different attestation form should be used. This form must be completed before funding can begin.

  • The funding is available for a five-year period that starts on the earlier of the following dates:

    • the date that the person first received therapy related to the alleged sexual abuse (the
    therapy can take place at any time after the abuse occurred) for which the person is
    requesting funding, or
    • the date it is alleged, in a complaint or report, that the person was sexually abused by
    an optometrist while the person was a patient of the optometrist.

    To receive the full benefit of the funding, applicants should submit their applications as early as

  • If you want to apply for this funding, please contact the College:

    Tel: 416-479-9295
    Fax: 647-417-6862
    Toll Free: 1-833-402-4819

  • College staff will confirm receipt of your application, and will tell you whether any additional information is required. You will also be notified of the timelines associated with the PRC’s review of your application.

  • No. The PRC will make its decision based on documentation only.

  • No.

  • You and your therapist or counsellor must keep all information obtained through the application for funding process, including the fact that funding has been granted, confidential. A decision by the PRC that you are eligible for funding does not constitute a finding of professional misconduct against the optometrist and shall not be considered by any other Committee of the College dealing with the matter.

  • The law sets out a maximum amount of funding that can be awarded, based on a formula provided in the regulation. While the maximum amount will vary depending on specific circumstances, it is approximately $16,000.00. Once a patient’s eligibility is determined and the application is processed, the College will notify the applicant of the amount of funding they will receive. In some circumstances, if the services being used are also covered by OHIP or a private insurance plan, the College would only pay the amount not covered.

  • Yes. The legislation currently specifies the funding must be used only to pay for therapy or counselling and can be paid only to your therapist or counsellor. Funding for any other purposes may be approved in the future but is currently not available. The PRC will consider specific requests for therapy or counselling and will determine whether it is captured by the legislation.

  • The funding for therapy and counselling is meant to assist you in dealing with the effects of the alleged sexual abuse by an optometrist. These funds are allocated in such a way that you can find a type of therapy or counselling that works best for you. There are many types of therapists/counsellors that can be extremely helpful, and it can be a difficult choice. Some of the things you may wish to consider are:

    • Previous training or experience in treating the effects of sexual abuse.
    • The number of sessions you need to attend, based on your counsellor’s experience and
    expertise. If you exceed the maximum amount approved for you, you must pay the
    • Is the therapist or counsellor a registered member of a regulated health profession? If not, you have no way of knowing whether he or she is appropriately qualified to practice. You may also not have a governing body to contact if you have concerns about the therapist’s conduct or skills.

  • Yes, up to the maximum amount awarded by the PRC. The College will process the invoices as they come in to the College.

  • The College will send you periodic reports keeping you informed as to how much money is left for the costs of your therapy. You can contact us if you wish to receive additional information.

  • If you want to apply for this funding, please contact the College:

    Tel: 416-479-9295
    Fax: 647-417-6862
    Toll Free: 1-833-402-4819