Opthalmology

All referral forms on this website are also available as eForms for OSCAR, Avaros, Indivicare, and ACCURO EMRs. You can download some of the premade forms here from WorldEMR or fill the contact form below for any other eForms that are not listed for your EMR.

Clinics

Clinic	Services	Location	Patient Handout	Contact	Information
Acute Care Eye Clinic – Ivey Eye Institute	1. Urgent Ophthalmology Open 24/7 usually seen within 24 hours	St Joseph’s Hospital – Ivey Eye Institute	Directions	Phone: 519-646-6100 ext. 66018Call Resident On-call for Urgent Matters 519-646-6000	Website

London Physicians

London Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Allen, Larry	1. Comprehensive Ophthalmology 2. Oculo-Plastic Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6366 Fax: 519-646-6418	Fax consult
Dr. Anderson, Matthew	1. Comprehensive Ophthalmology 2. Retina	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-682-8250 Fax: 519-646-6251	Fax consult
Dr. Bursztyn, Lulu	1. Comprehensive Ophthalmology 2. Neuro-ophthalmology 3. Cataract 4. Botox Treatment	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6214 Fax: 519-646-6129	Fax consult
Dr. Fraser, John	1. Neuro-ophthalmology ONLY (Neurologist)	LHSC – University Hospital	Generic Form	Phone: 519-663-3702 Fax: 519-663-3999	Fax consult
Dr. Gonder, John	1. Vitreo Retinal Surgery & Diseases	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8206 Fax: 519-646-6314	Fax consult
Dr. Hooper, Philip	1. Vitreo Retinal Surgery & Diseases	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8312 Fax: 519-646-6160	Fax consult
Dr. Hutnik, Cindy	1. Comprehensive Ophthalmology 2. Glaucoma 3. Cataracts	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6272 Fax: 519-646-6410	Fax consult
Dr. Iordanous, Yiannis	1. Comprehensive Ophthalmology (Adult & Peds) 2. Strabismus Surgery 3. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6074 Fax: 519-646-6112	Fax consult
Dr. Li, Bo	1. Cataract Surgery 2. Anterior Segment Surgery (Complex)	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6287 Fax: 519-646-6216	Fax consult
Dr. Lin, Tony	1. Glaucoma 2. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6225 Fax: 519-646-6218	Fax consult
Dr. Makar, Inas	1. Pediatric Ophthalmology 2. Adult & Pediatric Strabismus	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8281 Fax: 519-646-6149	Fax consult
Dr. Mather, Rookaya	1. Cornea (Cataract, Laser) 2. External Disease 3. Inflammatory & Infectious Eye Diseases	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6409 Fax: 519-646-6394	Fax consult
Dr. McIlraith, Ian	1. Glaucoma 2. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6208 Fax: 519-646-6412	Fax consult
Dr. Motolko, Michael	1. Glaucoma 2. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8131 Fax: 519-646-6273	Fax consult
Dr. Li, Bo	1. Ophthalmology	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6287 Fax: 519-646-6216	Fax consult
Dr. Proulx, Alain	1. Comprehensive Ophthalmology 2. Neuro-ophthalmology	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6315 Fax: 519-646-6193	Fax consult Speaks French
Dr. Sharan, Sapna	1. Pediatric Ophthalmology 2. Adult & Pediatric Strabismus 3. Pediatric Glaucoma	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8795 Fax: 519-646-6094	Fax consult Speaks Hindi
Dr. Sheidow, Thomas	1. Vitreo Retinal Surgery & Diseases ONLY (Including Peds)	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8133 Fax: 519-646-6355	Fax consult
Dr. Tingey, David	1. Glaucoma 2. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8351 Fax: 519-646-6076	Fax consult

London Community Physicians

London Community Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Bains, Richard	1. Comprehensive Ophthalmology 2. Laser Refraction	TLC Laser Center 142 Fullarton St London, ON N6A 0A4	Generic Form	Phone: 519-438-2020 Fax: 519-438-2021	Fax consult Website
Dr. Schulz, David	1. Comprehensive Ophthalmology	Seaforth Community Health Centre 28 Centennial Drive, Seaforth, Ontario	Generic Form	Phone: 226-633-5888 Fax: 226-633-5777	Fax consult Website
Dr. Mailer, Colin	1. Comprehensive Ophthalmology	Hakim London King 215 King St London, ON N6A 1C9 Peaker Optical 1984 Dundas St E London, ON N5V 1P5	Generic Form	Phone: Hakim 519-439-0277 Peaker 519-451-5417 Fax: Hakim 519-439-0279 Peaker 519-451-0644	Fax consult Speaks French, German, Spanish

St. Thomas Physicians

St. Thomas Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Brydon, Wilfred	1. Comprehensive Ophthalmology *NO vitreal injections for diabetes or macular degeneration	St Thomas Family Health Centre 230 First Ave, Suite 110 St Thomas, ON N5R 4P5	Generic Form	Phone: 519-633-9846 Fax: 519-637-8321	Fax consult

Strathroy Physicians

Strathroy Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Rogelstad, Michael	1. Comprehensive Ophthalmology	Strathroy Middlesex General Hospital	Generic Form	Phone: 519-246-1610 Fax: 519-246-1611	Fax consult

Woodstock Physicians

Woodstock Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Johnson, David	1. Comprehensive Ophthalmology 2. Refractive Laser Surgery	695 Canterbury St, Unit 2 Woodstock, ON N4S 8W7	Generic Form	Phone: 519-537-5052 Fax: 519-539-0476	Fax consult
Dr. Lui, Derek	1. Comprehensive Ophthalmology 2. Vitreoretinal Diseases 3. Glaucoma 4. Cataract Surgery	369 Hunter St Woodstock, ON N4S 4G3	Generic Form	Phone: 519-421-1851 Fax: 519-421-9234	Fax consult

Stratford Physicians

Stratford Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Bains, Richard	1. Comprehensive Ophthalmology 2. Laser Refraction	London Eye Surgery 1140 Southdale Rd W London, ON N6B 3R8 28 Centennial Drive Seaforth, ON N0K 1W0	Generic Form	Phone: London 519-204-8200 Seaforth 519-527-8424 Fax: London 519-204-8700 Seaforth 519-527-8423	Fax consult Website

Pediatric Physicians

Pediatric Physicians	Subspecialty / Interest	Location	Form	Contact	Information
Dr. Iordanous, Yiannis	1. Comprehensive Ophthalmology (Adult & Peds) 2. Strabismus Surgery 3. Cataract Surgery	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-646-6074 Fax: 519-646-6112	Fax consult
Dr. Makar, Inas	1. Pediatric Ophthalmology 2. Adult & Pediatric Strabismus	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8281 Fax: 519-646-6149	Fax consult
Dr. Sharan, Sapna	1. Pediatric Ophthalmology 2. Adult & Pediatric Strabismus 3. Pediatric Glaucoma	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8795 Fax: 519-646-6094	Fax consult Speaks Hindi
Dr. Sheidow, Thomas	1. Vitreo Retinal Surgery & Diseases ONLY (Including Peds)	St Joseph’s Hospital – Ivey Eye Institute	Generic Form	Phone: 519-685-8133 Fax: 519-646-6355	Fax consult

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