Universal eye health is a component of universal health care, which member states of the World Health Organization have supported in principle through their endorsement of the Global Action Plan for the Prevention of Avoidable Blindness and Visual Impairment (2014-2019). While much of the world's attention has been on addressing the needs of developing countries which suffer significant shortcomings in terms of effective and accessible eye care services, similar access inequities exist in developed nations such as Canada. The Canadian health system is based on the principle of universal health coverage; yet, for the majority of the population, access to primary eye care services such as an eye examination and spectacles is an out-of-pocket expense. Therefore, despite the global call for universal eye health, Canada has still not made relevant policy shifts in terms of addressing the structural barriers to all its citizens accessing primary eye care services within its health system, despite active advocacy efforts of key stakeholder groups in eye health. There is, therefore, an inescapable reality of unmet eye care needs, which Canada must address if it is to meet the World Health Organization's goals of universal eye health.