Reviewed August 2022

The Canadian Ophthalmological Society (COS) and its subspecialty society, the Canadian Cornea, External Disease & Refractive Surgery Society (CCEDRSS), are committed to excellence in ophthalmology. Excellence requires adherence to the highest ethical standards in all professional activities, including marketing and advertising. Our guiding principle is that the welfare of the patient is paramount. Advertising is ethical when it informs and educates the patient, when it does not confuse or mislead, and when it augments – but does not substitute for – a full conversation between the patient and the surgeon. There is no substitute for patient counseling, which can only be provided in a one-on-one setting.

COS and the CCEDRSS believe that, as a form of patient education, advertising is governed by the ethical guidelines and policies that cover patient education, including the guidelines of the Provincial Colleges of Physicians and Surgeons.

In particular, we agree with the American Academy of Ophthalmology (AAO) that good patient education:

• Is clear, accurate, up-to-date and thorough;
• Avoids misleading statements;
• Is not overstated and does not instill unrealistic expectations in patients; and
• Serves as a springboard for the oral conversation with the patient.

COS and the CCEDRSS would recommend that our members conform to these standards.

We also agree with and would recommend that our members give consideration to the joint statement of the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgeons (ASCRS), and the International Society of Refractive Surgery of the American Academy of Ophthalmology entitled Guidelines for Refractive Surgery Advertising Policy.

No set of guidelines can anticipate every possible advertising claim or expression. Ultimately, advertising is an ethical matter, and we expect our members to conform to the highest ethical standards in advertising as in every other aspect of their practices.

April 2012

The Canadian Ophthalmological Society’s (COS) expert working group on driving and vision standards provided recommendations on the visual acuity and visual field needed for safe driving in Canada.

These recommendations are published in Section 12: Vision of the Canadian Medical Association Driver’s Guide, 8th edition.

COS’s Vision Standards for Driving Committee revisited the vision section of the guide in April 2012 and indicated no changes were required at this time.

Background

When a patient is visually impaired, the physician should inform the patient of the nature and extent of the visual defect and, if required, report the problem to the appropriate authorities.

When minor visual defects are not accompanied by cognitive defects or neglect, most drivers are capable of compensating for partial defects. For example, most people adapt to the loss of an eye in a period of several months.

Recent studies indicate that experienced drivers can compensate for a loss of visual acuity if they are in familiar surroundings and they limit their speed.  In these circumstances, functional assessments are indicated.

Section 12 presents information about the recommended visual acuity and visual field needed for safe driving (section 12.2). Actual standards for these functions are set by provincial or territorial licensing authorities and may vary among jurisdictions as well as varying from the recommendations in Section 12, which are based on expert opinion.

Section 12 also presents information about other important visual functions that should be taken into consideration in determining fitness to drive (section 12.3) and recommendations for exceptional cases that require individual assessment (section 12.4).

It also provides further detail on recommended testing procedures (addendum 1), a list of medical conditions with increased risk for vision problems and a discussion of the use of vision aids in driving (addendum 2).

December 2009

National retinoblastoma strategy: Canadian guidelines for care

These guidelines are based on the best available evidence and expert opinion, and are intended to optimize patterns of clinical practice. They are not to be prescriptive or replace clinical judgement, nor restrict innovation. Healthcare professionals must always consider the needs, preferences, values, financial and personal circumstances of individual patients and work within the realities of their healthcare setting. Inequities in staffing, financial, equipment, and healthcare resources in different jurisdictions may impact upon physician and patient options and decisions. As the general nature of guidelines cannot provide individualized guidance for all patients in all circumstances, this document should not be used as a legal resource.