February 27, 2015 | POSTED BY | Events., Post-Optometry School
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Disclosure: The information presented is based on the U.S. Citizen and Immigration Services website and is subject to change without notice. Please consult an immigration lawyer regarding your specific situation. This article is an overview for Canadian students studying in the U.S. and is not updated on a regular basis.

Optometrist and woman at eye examination with phoropterOptometry is a legislated profession in both the U.S. and Canada, and is therefore limited by the laws mandated by the government. There are many advantages and disadvantages to either country’s medical model, but the current American laws governing optometry allow ODs to perform more procedures and prescribe a more expansive list of medications compared to what is allowed under current Canadian laws. To date, there is no province or territory in which injections or lasers can be used in Canada, while in the US, there are three states that allow lasers, and 10 states that allow
injections. It is an exciting opportunity for optometrists to practice as much of what is taught in optometry school as possible, therefore working in the U.S. can be advantageous to maintaining clinical skills such as dilation and irrigation, injections and lasers.

Canadians who wish to work in the U.S. can do so by using their OPT VISA after graduation if they are American trained. During their OPT year, they can work in a residency program or at any other place of employment. Non-American trained Canadians must obtain an H1B visa to apply for residency or employment. Currently, ICONOVAMCONSUOCOUAB and UMSL are the only optometry schools in the U.S. that accept Canadian trained Canadian students. Upon graduating from a residency program, employment can be obtained at a teaching institution, and there is no limit to the number of H1B visas available with this opportunity.  In other words, it is likely for a Canadian to obtain full time employment for 3-6 years under an H1B visa if working at an educational institution. However, employment at a private practice is a different story, not only would you have to find an employer to sponsor your H1B, your application is also entered in a lottery and is not guaranteed to be accepted.

Here is some insight on residency, the application process, and employment in the U.S. from three Canadian optometrists who currently work as full time faculty at ICO:

FromsteinDr. Stephanie Fromstein completed her undergraduate degree at McGill University, Doctorate of Optometry at NOVA, and lastly a residency in Cornea and Contact lens at ICO.

  • On residency: “I applied to programs in Canada and the US, but the time frames for filling the positions were completely different. Ultimately I found out about being matched to ICO before I even interviewed in Canada and it was an offer I couldn’t refuse.”
  • On scope of practice: “The scope of practice between Ontario and Illinois are quite similar, the biggest discrepancy is with orals and secondary glaucomas.”
  • On the application process: “I would talk to an immigrations lawyer since the rules are often changing and the process can be confusing to navigate on your own. It wasn’t the most straightforward process for me but it was definitely worthwhile.” 


MorettinDr. Christina Morettin completed her undergraduate degree at Queens University, Doctorate of Optometry at the University of Waterloo, and her Ocular Disease residency at ICO.

  • On residency: “I wanted to feel more comfortable with ocular disease, and the residency opportunities was provided more in depth in the U.S. Chicago has a very under served population; the Illinois Eye Institute is one of the biggest eye care referral centers, and we get to see a lot of advanced disease. We are the first point of care for these patients and it is a unique experience to work with ODs and MDs that treat these difficult cases.”
  • On scope of practice: It is a hard comparison with scope of practice between provinces and states. There is a big gap between Canadian provinces, but the U.S. also faces a similar issue. Some states allow optometrists to perform full scope medical eye care including laser procedures while other states have strict restrictions on what they can and cannot prescribe.”
  • On the application process: “It can be a difficult road, as long as you know what you want to do, they will guide you the right way to approach it.”


Angela_To_OD_largeDr. Angela To completed her undergraduate degree at the University of Calgary, Doctorate of Optometry at ICO, and her Pediatrics residency at ICO.

  • On scope of practice: “What drew me to staying in the U.S. after my residency was the widened scope of practice in the U.S. I also really like variety, in academia, I get to teach in lecture, in lab and also in as a clinical attending, I get to provide direct care.” (There are only two schools of optometry in Canada, and therefore teaching opportunities are not as abundant compared to the 21 American schools and colleges of optometry.)
  • On employment: “I would be prepared to work in rural or underserved areas for corporate optometry.”

There are some corporate companies such as National Vision that support Canadian optometrists to work in the U.S. Ms. Denise Nelson, Regional Director of Professional Services for National Vision, suggests that optometry students should make a connection with a representative in January of their fourth year. The stipulations of the VISA include “full time employment, but there is no minimum years of service for the H1. There are no states that National Vision restricts Canadian ODs to work, however the application is based on how competitive a certain location is. The student is responsible for the F1 fees, and the H1 fees are paid by the company.”

For further questions regarding corporate optometry at National Vision, contact Ms. Nelson at Denise.Nelson@nationalvision.com.

Do you have similar experience working as a Canadian OD in the US? Please share in the comments below!