Primary open angle glaucoma is a chronic
optic neuropathy often requiring lifelong treatment. Patient compliance, adherence and persistence with
therapy play a vital role in improved outcomes by reducing morbidity and the economic consequences that are associated with
disease progression. A literature review including searches of The Cochrane Library, MEDLINE, PubMed, conference proceedings, and bibliographies of identified articles reveals the enormous public health burden in various populations due to the impact of
glaucoma associated
visual impairment on the overall quality of life eg, fear of
blindness, inability to work in certain occupations, driving restrictions, motor vehicle accidents, falls, and general health status. Providing specific definitions for the frequently misunderstood terms "compliance, persistence and adherence" with reference to medication use is central not only for monitoring patients'
drug dosing histories and clinical outcomes but also for subsequent research. In this review article, a summary of the advantages/disadvantages including cost-effectiveness of various medical approaches to
glaucoma treatment, techniques employed for measuring patient compliance and actual patient preferences for
therapy are outlined. We conclude by identifying the key barriers to ongoing treatment and suggest some best practices to enhance compliance and persistence.