WATERLOO -- As of Wednesday, optometrists across the province began job action and are no longer serving patients covered by OHIP.

That means kids under 18, those 65 and older, and people with certain eligible eye conditions won't be getting appointments.

"I got a phone call from my optometrists yesterday cancelling my appointment," said Waterloo resident Elizabeth Wharton, who just had cataract surgery and needs a new prescription, but can't get one.

Under Ontario law, optometrists aren't allowed to take any payment from OHIP-covered patients, even in the event of a strike.

The base of the job action is that doctors are only reimbursed by the government about $45 for each patient, but the argument is that the real cost of an appointment is about $80.

"We don't want to have to pay to see the patients that we're serving because that creates a system where there is a lower level of care that we're able to provide," said Dr. Sheldon Salaba, president of the Ontario Association of Optometrists (OAO).

The province did offer a $39 million retroactive payment to be split among 2,500 optometrists, equally about $16,000 each.

The government also offered to increase the $45 reimbursement to about $49, but the OAO says that's not enough.

Dr. Salaba said the OAO isn't willing to go back to the bargaining table until the province commits to covering the full $80 operating cost per patient.

Guelph-based optometrist Dr. Mark Lukito said about 60 to 80 per cent of daily appointments are covered by OHIP. In his 15 years in the industry, he said he's never had a raise because paying the bills for necessary equipment comes first.

"We would love to have different equipment that we just don't have, we have to pay off our current equipment," he said.

When asked to comment on Thursday, Ontario's Ministry of Health responded with the same statement they issued Wednesday.

"I want to be clear that our government will continue to fund these optometry services through OHIP. Any decision to withdraw services is the decision of individual optometrists," Health Minister Christine Elliott said in an emailed statement. "The College of Optometrists of Ontario has made clear that if an individual optometrist decides to withhold care from a patient, they are expected to take steps to ensure the patient can continue to receive appropriate care."

Elliott also called the government's offer "fair and reasonable" and said she is disappointed with the OAO's decision to decline to resume mediation.

Meanwhile, Wharton said she wants to see fair pay for optometrists and is willing to wait longer for an appointment but is worried about the safety of others.

"I hope the government does something very soon about this," she said. "We need to get it resolved."