Japanese Journal of Ophthalmology

, Volume 57, Issue 1, pp 47–56 | Cite as

Noncompliance with glaucoma medication in Korean patients: a multicenter qualitative study

  • Myoung Hee Park
  • Kyu-Dong Kang
  • Jungil MoonEmail author
  • The Korean Glaucoma Compliance Study Group
Clinical Investigation



To investigate the common side effects of topical antiglaucoma medication, factors affecting compliance, and the utilization of herbal medicine for glaucoma treatment in South Korea.

Patients and methods

A cross-sectional multicenter hospital-based study. In-depth interviews using a structured questionnaire were conducted with 581 individuals diagnosed with glaucoma. Additional eligibility requirements were: all participants were diagnosed with glaucoma in one or both eyes and prescribed eye drops at least one month before the start of the study, and were in a suitable condition for an interview. The frequency of response for each category in the interview questionnaire was analyzed.


Conjunctival injection, a stinging sensation, and blurred vision were the most frequently reported side effects, among which blurred vision was the most unbearable. Patient knowledge of glaucoma was the only factor associated with the patient’s self-evaluation of compliance. Forgetfulness was the most common reason for nonadherence. Only 2.9 % of patients were taking herbal medicine.


Physicians should address a patient’s complaint of blurred vision resulting from medication. Complete initial explanation of the consequences of nonadherence and of the potential vision loss from glaucoma are critical elements in improving patient adherence in Asian populations.


Blurred vision Conjunctival injection Topical antiglaucoma medication Noncompliance 



This study was supported by the investigator-initiated research study program fund granted by Pfizer (grant number IG-KOR-028-2008).


  1. 1.
    Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006;90:262–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Stamper RL, Liberman MF, Drake MV. Becker–Shaffer’s diagnosis and therapy of the glaucomas. 8th ed. Mosby: Elsevier; 2009.Google Scholar
  3. 3.
    Spaeth GL. Visual loss in a glaucoma clinic: I. Sociologic considerations. Invest Ophthalmol. 1970;9:73–82.PubMedGoogle Scholar
  4. 4.
    Ashburn FS Jr, Goldberg I, Kass MA. Compliance with ocular therapy. Surv Ophthalmol. 1980;24:237–48.PubMedCrossRefGoogle Scholar
  5. 5.
    DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42:200–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Schwartz GF, Quigley HA. Adherence and persistence with glaucoma therapy. Surv Ophthalmol. 2008;53:S57–68.PubMedCrossRefGoogle Scholar
  7. 7.
    MacKean JM, Elington AR. Compliance with treatment of patients with chronic open-angle glaucoma. Br J Ophthalmol. 1983;67:46–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Taylor SA, Galbraith SM, Mills RP. Causes of non-compliance with drug regimens in glaucoma patients: a qualitative study. J Ocul Pharmacol Ther. 2002;18:401–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Tsai JC. A comprehensive perspective on patient adherence to topical glaucoma therapy. Ophthalmology. 2009;116:S30–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Stryker JE, Beck AD, Primo SA, Echt KV, Bundy L, Pretorius GC, et al. An exploratory study of factors influencing glaucoma treatment adherence. J Glaucoma. 2010;19:66–72.PubMedCrossRefGoogle Scholar
  11. 11.
    Quek DTL, Ong GT, Perera SA, Lamoureux EL, Aung T. Persistence of patients receiving topical glaucoma monotherapy in an Asian population. Arch Ophthalmol. 2011;129:643–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Patel SC, Spaeth GL. Compliance in patients prescribed eye drops for glaucoma. Ophthalmic Surg. 1995;26:233–6.PubMedGoogle Scholar
  13. 13.
    Rotchford AP, Murphy KM. Compliance with timolol treatment in glaucoma. Eye. 1998;12:234–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Foster PJ, Buhrmann R, Quigley HA, Johnson GJ. The definition and classification of glaucoma in prevalence surveys. Br J Ophthalmol. 2002;86:238–42.PubMedCrossRefGoogle Scholar
  15. 15.
    Khandekar R, Shama ME, Mohammed AJ. Noncompliance with medical treatment among glaucoma patients in Oman—a cross-sectional descriptive study. Ophthalmic Epidemiol. 2005;12:303–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Tsai JC, McClure CA, Ramos SE, Schlundt DG, Pichert JW. Compliance barriers in glaucoma: a systematic classification. J Glaucoma. 2003;12:393–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Kass MA, Gordon M, Meltzer DW. Can ophthalmologists identify patients defaulting from pilocarpine therapy? Am J Ophthalmol. 1986;101:524–30.PubMedGoogle Scholar
  18. 18.
    Norell SE. Accuracy of patient interviews and attempts by clinical staff in determining medication compliance. Soc Med Sci. 1981;15:57–61.CrossRefGoogle Scholar
  19. 19.
    Kass MA, Meltzer DW, Gordon M, Cooper D, Goldberg J. Compliance with topical pilocarpine treatment. Am J Ophthalmol. 1986;101:515–23.PubMedGoogle Scholar
  20. 20.
    Wilensky J, Fiscella RG, Carlson AM, Walt J. Measurement of persistence and adherence to regimens of IOP-lowering glaucoma medications using pharmacy claims data. Am J Ophthalmol. 2006;141:S28–33.PubMedCrossRefGoogle Scholar
  21. 21.
    Nordstrom BL, Friedman DS, Mozaffari E, Quigley HA, Walker AM. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol. 2005;140:598–606.PubMedCrossRefGoogle Scholar
  22. 22.
    Van Buskirk EM. The compliance factor. Am J Ophthalmol. 1986;101:609–10.PubMedGoogle Scholar
  23. 23.
    Friedman DS, Hahn SR, Gelb L, Tan J, Shah SN, Kim EE, et al. Doctor-patient communication, health-related beliefs, and adherence in glaucoma. Results from the Glaucoma Adherence and Persistency Study. Ophthalmology. 2008;115:1320–7.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2012

Authors and Affiliations

  • Myoung Hee Park
    • 1
    • 3
  • Kyu-Dong Kang
    • 2
    • 3
  • Jungil Moon
    • 1
    • 3
    Email author
  • The Korean Glaucoma Compliance Study Group
  1. 1.Department of OphthalmologyYeouido St. Mary’s HospitalSeoulKorea
  2. 2.Incheon St. Mary’s HospitalIncheonKorea
  3. 3.School of MedicineThe Catholic University of KoreaSeoulKorea

Personalised recommendations