Traumatic Posterior Chamber Intraocular Lens Dislocation into the Subconjunctival Space

Purpose@#Here we report a case of posterior chamber intraocular lens (IOL) dislocation into the subconjunctival space (pesudophacocele) following ocular trauma.Case summary: A 66-year-old male presented with ocular pain and decreased vision in the right eye following trauma with a metallic rod. The patient had a history of trabeculectomy, glaucoma drainage device implantation, transscleral cyclophotocoagulation, and cataract surgery for uveitic glaucoma and a cataract in the right eye. On examination, vision was hand movement, the intraocular pressure was 3 mmHg, and subconjunctival hemorrhage and hyphema were observed. After the resolution of hemorrhage, uveal tissue prolapse was seen nasally behind the corneal limbus and the IOL was found to be dislocated into the nasal subconjunctival space. There were no changes in the filtering bleb and tube compared to the pre-trauma status. The IOL was removed through a conjunctival incision because the patient refused any active treatment. @*Conclusions@#Pesudophacocele developed in a patient who had a history of glaucoma and cataract surgery in the injured eye. The IOL could not be assessed immediately after the trauma because of subconjunctival hemorrhage and hyphema. When the status of IOL is unclear or suspected to be dislocated after trauma, the possibility of pseudophacocele should be considered, in addition to the dislocation into the vitreous cavity.

Correlation between Interocular Asymmetry of Corneal Hysteresis and Visual Field Defect in Glaucoma

Purpose@#To evaluate the relationship between interocular asymmetries of corneal hysteresis (CH) and visual field defects in Korean patients with glaucoma. @*Methods@#A total of 444 eyes from 222 participants with glaucoma in at least one eye were enrolled. CH was measured using an ocular response analyzer (Reichert Technologies Inc). Eyes of each participant were classified into “better eye” and “worse eye” based on the mean deviation (MD) value of visual field test. The correlation between interocular differences in intraocular pressure, axial length, central corneal thickness, CH, and MD values was evaluated using Spearman correlation analysis. To exclude the possible effect of antiglaucoma medication on corneal properties, additional analyses were performed on eyes without any glaucoma treatment at the time of CH measurement (treatment-naive group). @*Results@#Median (interquartile range) MD value was –3.71 dB (–6.87 to –1.30 dB) in the better eye and –10.20 dB (–16.32 to –5.62 dB) in the worse eye. When the correlation between the asymmetry of the MD value and asymmetry of intraocular pressure, axial length, central corneal thickness, and CH were evaluated, only interocular differences in CH were significantly associated with interocular differences in MD values (rho = 0.214, p = 0.001). Among the 222 participants, 60 (27.0%) were treatment-naive group. In these eyes, interocular differences in CH were also significantly associated with interocular differences in the MD values (rho = 0.285, p = 0.029). @*Conclusions@#The interocular asymmetry of CH was significantly correlated with the interocular asymmetry of visual field defects in glaucoma.

Risk of Developing Congenital Glaucoma in Premature Infants with Large Cup/Disc Ratio

Purpose@#To investigate the risk of congenital glaucoma development in premature infants with large cup/disc ratios: a long-term follow-up study. @*Methods@#The medical records of premature infants with cup/disc ratios of at least 0.3 were retrospectively reviewed. Ophthalmic examinations, including measurements of intraocular pressure (IOP) corneal diameter, and dilated fundoscopy, were periodically performed. Changes in the cup/disc ratio from the first examination to the last follow-up were sought, and clinical factors associated with such changes were analyzed. In addition, glaucoma development was investigated. @*Results@#Seventy-four patients were included; they were monitored for up to 33.96 ± 19.86 months (based on corrected age). At first examination, the mean IOP was 17.12 ± 4.01 mmHg and the horizontal corneal diameter 10.34 ± 0.83 mm. The mean cup/disc ratio was 0.54 ± 0.14 at the first visit and increased significantly to 0.57 ± 0.14 at the last follow-up (p < 0.001). A small baseline cup/disc ratio was associated with a greater change in the cup/disc ratio (regression coefficient β = -0.111, p = 0.028). We found no significant association of such change with gestational age, birth weight, IOP, or corneal diameter. We encountered no case of congenital glaucoma. @*Conclusions@#Even if the cup/disc ratio is at least 0.3 in premature infants, the risk of glaucoma does not seem to be high if the IOP is not high. Prospective studies on more patients are needed.

Clinical Outcomes of Applying Therapeutic Contact Lenses and Eye Drops after Cataract Surgery

Purpose@#To investigate the safety of applying therapeutic contact lenses and eye drops after cataract surgery. @*Methods@#Immediately after cataract surgery, 947 eyes (group 1) used therapeutic contact lenses and eye drops and 914 (group 2) applied antibiotic ointment and wore a gauze eye patch for the first postoperative day. Clinical outcomes including best corrected visual acuity (BCVA), IOP, degree of anterior chamber inflammation, wound leakage, and postoperative endophthalmitis were compared in the two groups 1 day, 1 week, and 1 month after surgery. @*Results@#There were no significant differences in the mean pre- and postoperative BCVA and IOP at 1 day, 1 week, and 1 month between groups 1 and 2. There was no difference in anterior chamber inflammation between the two groups at 1 day (p = 0.302), 1 week (p = 0.437), or 1 month (p = 0.960) after surgery. On the first postoperative day, 10 eyes in group 1 and nine eyes in group 2 had wound leakage (p = 1.000). There was no endophthalmitis in either group. @*Conclusions@#The risk of postoperative complications in group 1 was not higher than in group 2. Therefore, wearing therapeutic contact lenses and using eye drops is a relatively safe management method after cataract surgery.

Surgical Outcomes of the Ahmed Valve Implantation Following Trans-scleral Cyclophotocoagulation

Purpose@#To determine the intraocular pressure (IOP) lowering effect and complications of Ahmed valve implantation (AGV) in patients who underwent cyclophotocoagulation (CPC). @*Methods@#Patients who underwent AGV after CPC in group 1, those who underwent CPC after AGV in group 2, and patients who underwent repeated CPC in group 3 were included in this retrospective observational study. Changes in IOP, number of glaucoma eye drops, and best corrected visual acuity (BCVA) were analyzed before and 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and postoperative complications were analyzed. @*Results@#Eight patients in group 1, 10 patients in group 2, and seven patients in group 3 were included in the analysis. Preoperative IOP was 45.6 ± 15.5, 29.3 ± 5.6, and 43.4 ± 14.4 mmHg in the three groups, respectively, and the number of glaucoma eye drops was 3.8 ± 0.7, 3.9 ± 0.3, and 3.7 ± 1.0 in the three groups, respectively. At 12 months postoperatively, IOP decreased significantly in all three groups compared to preoperatively (all p < 0.05), and the number of glaucoma eye drops was also significantly reduced (all p < 0.05). Among patients with preoperative BCVA of 0.02 decimal or higher, postoperative BCVA decreased in two patients in group 2 and one in group 3 (p = 0.380). Hypotony occurred in one patient in group 1 and two patients in group 3 (p = 0.383), and among them, one patient in group 1 and one patient in group 3 progressed to the phthisis (p = 0.940). @*Conclusions@#In patients whose IOP cannot be controlled after CPC, AGV is expected to be used as a relatively safe and effective treatment method for lowering IOP.

Can reactogenicity predict immunogenicity after COVID-19 vaccination?

Background/Aims@#This study aimed to assess the association between local and systemic reactogenicity and humoral immunogenicity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. @*Methods@#Adverse events were prospectively evaluated using an electronic diary in 135 healthy adults who received a SARS-CoV-2 vaccine (AZD1222, AstraZeneca/Oxford, n = 42; or BNT162b2, Pfizer/BioNTech, n = 93). We semi-quantitatively measured anti-S1 immunoglobulin G (IgG) using an enzyme-linked immunosorbent assay at baseline, 3 weeks after the first dose of AZD1222 or BNT162b2, and 2 weeks after the second dose of BNT162b2. We evaluated the association between the maximum grade of local or systemic adverse events and the anti-S1 IgG optical density using multivariate linear regression with adjustment for age, sex, and use of antipyretics. @*Results@#The median age of the 135 vaccinees was 30 years (36 years in the AZD1222 group and 29 years in the BNT162b2 group) and 25.9% were male (9.5% in the AZD1222 group and 33.3% in the BNT162b2 group). Local and systemic adverse events were generally comparable after the first dose of AZD1222 and the second dose of BNT162b2. The grades of local and systemic adverse events were not significantly associated with anti-S1 IgG levels in the AZD1222 or BNT162b2 group. @*Conclusions@#Local and systemic reactogenicity may not be associated with humoral immunogenicity after SARS-CoV-2 vaccination.

Comparison of Pericardial Patch Graft Thickness for Glaucoma Implant, Using Anterior Segment Optical Coherence Tomography

Purpose@#To compare the thickness of the processed pericardial patch graft for glaucoma implant tube coverage using anterior segment optical coherence tomography (AS-OCT). @*Methods@#Thicknesses of seven samples of two pericardial patch grafts (Tutoplast pericardium, IOP Inc, Costa Mesa, CA, USA; pericardium LYO, DCI Donor Services, Inc., Nashville, TN, USA) were measured using AS-OCT (CASIA2, Tomey Corporation, Nagoya, Japan). The thickness of each sample was measured at the center and eight points with 45-degree angular distance, 2 mm from the center. The thickness was measured using AS-OCT program tools. @*Results@#The median thicknesses were 219 μm for Tutoplast pericardium and 157 μm for pericardium LYO. Tutoplast pericardium was significantly thicker than pericardium LYO (p = 0.001); pericardium LYO had a wider interquartile range within each sample, compared to Tutoplast pericardium (p = 0.017). @*Conclusions@#The thickness of the Tutoplast pericardium was greater and less variable than that of the pericardium LYO. These findings should be considered when choosing processed pericardium for coverage of glaucoma implants.

Optic Nerve Head Parameters of Healthy Children as Measured by OpticalCoherence Tomography

Purpose@#To investigate optic nerve head (ONH) parameters as measured using optical coherence tomography (OCT) in healthychildren. @*Methods@#Peripapillary areas were scanned by spectral-domain OCT in healthy eyes of children aged 5–17 years. ONH parameterswere automatically determined by OCT, including the rim area, disc area, cup-to-disc ratio, and cup volume. The effects ofage and refractive error on ONH parameters were evaluated. @*Results@#A total of 352 eyes of 352 subjects (mean age: 9.7 ± 3.6 years) were enrolled. The mean rim area, disc area, cup-to-discratio, and cup volume was 1.51 ± 0.27 mm2, 2.07 ± 0.39 mm2, 0.47 ± 0.16, and 0.163 ± 0.148 mm3, respectively. The mean rimarea, disc area, cup-to-disc ratio by age was 1.58 ± 0.29 mm2, 2.18 ± 0.35 mm2, and 0.48 ± 0.17 in 5- to 8-year-olds; 1.46 ± 0.24 mm2,2.04 ± 0.43 mm2, and 0.49 ± 0.15 for 9- to 12-year-olds; and 1.46 ± 0.22 mm2, 1.94 ± 0.35 mm2, and 0.44 ± 0.18 for 13- to17-year-old. Higher myopia and older age were associated with a smaller rim area (p < 0.05). @*Conclusions@#The mean rim area, disc area, and cup-to-disc ratio as measured using OCT in healthy children were 1.51 mm2,2.07 mm2, and 0.47, respectively. ONH parameters were significantly affected by age and refractive error.

Retinal Nerve Fiber Layer and Macular Retinal Ganglion Cell Layer Thicknesses in Healthy Korean Children

PURPOSE: To measure the thicknesses of the circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) by optical coherence tomography (OCT) in healthy Korean children and adolescents. METHODS: Circumpapillary RNFL and macular GCIPL thicknesses were measured by OCT in 352 healthy eyes of 352 children and adolescents (child-adolescent group) aged 5–17 years and in 159 healthy eyes of 159 adults (adult group) aged 18-75 years. The difference in RNFL and GCIPL thicknesses between the groups and the effects of age and refractive errors on the measurements were evaluated. RESULTS: The mean age of the children and adults were 9.7 ± 3.6 and 44.7 ± 15.7 years, respectively. The mean of the average RNFL and GCIPL thicknesses were 103.1 ± 9.2 and 85.7 ± 4.6 µm, respectively, in the children group and 97.8 ± 8.2 and 82.9 ± 4.4 µm, respectively, in the adult group. The child-adolescent group had greater RNFL and GCIPL thicknesses compared to the adult group in all areas (p < 0.05) with the exception of the RNFL thickness in the temporal quadrant (p = 0.555). A thinner RNFL and thinner GCIPL were significantly associated with older age and greater myopia (p < 0.001). CONCLUSIONS: The mean RNFL and GCIPL thicknesses measured by OCT in the healthy eyes of children and adolescents were 103.1 and 85.7 µm, respectively. Children and adolescents had a thicker RNFL and GCIPL compared to adults.

Fluid Dynamics of Small Diameter Tubes Used in Membrane-tube Type Glaucoma Shunt Devices

PURPOSE: To investigate the outflow characteristics of silicone tubes with intraluminal stents used in membrane-tube (MT) type glaucoma shunt devices. METHODS: The silicone tubes used in MicroMT (internal diameter of 100 µm with a 7-0 nylon intraluminal stent) and Finetube MT (internal diameter of 200 µm with a 5-0 nylon intraluminal stent) were connected to a syringe-pump that delivered a continuous flow of distilled water at flow rates of 2, 5, 10, and 25 µL/min. The pressures and resistances of tubes were measured at a steady flow rate with full-length, half-length, and absence of intraluminal stents. RESULTS: The mean outflow resistance of the two types of tubes ranged from 3.0 ± 1.9 to 3.8 ± 1.7 mmHg/µL/min with a full-length intraluminal stent, 1.8 ± 1.1 to 2.2 ± 1.1 mmHg/µL/min with a half-length intraluminal stent, and 0.1 ± 0.0 to 0.2 ± 0.0 mmHg/µL/min without an intraluminal stent. Theoretically, for a physiologic state with a flow rate of 2 µL/min and episcleral venous pressure of 6 mmHg, the mean pressures of tubes were expected to be 13.2 ± 3.0, 10.5 ± 2.4, and 6.4 ± 0.2 mmHg in MicroMT with full-length, half-length, and absence of intraluminal stents, respectively, and 12.5 ± 3.9, 9.6 ± 2.4, and 6.2 ± 0.2 mmHg in Finetube MT with full-length, half-length, and absence of intraluminal stents, respectively. The pressure variance also decreased with intraluminal stent retraction (p < 0.01). CONCLUSIONS: The small diameter tubes of 100 and 200 µm internal diameters, with 7-0 and 5-0 nylon intraluminal stents, respectively, used in the MT-type glaucoma shunt device showed safe and effective outflow characteristics.

A Comparison of Retinal Nerve Fiber Layer Thickness Measured Using Five Different Optical Coherence Tomography Devices

PURPOSE: To compare circumpapillary retinal nerve fiber layer (RNFL) thicknesses as measured using five different optical coherence tomography (OCT) devices. METHODS: RNFL thickness was measured in 32 healthy eyes of 32 subjects using a Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA), Spectralis OCT (Heidelberg Engineering, Heidelberg, Germany), Topcon DRI OCT (Topcon, Tokyo, Japan), RS-3000 Advance OCT (NIDEK, Aichi, Japan), and RTVue-100 (Optovue, Fremont, CA, USA). Global and quadrant (superior, nasal, inferior, and temporal) RNFL thicknesses were compared using repeated measures analysis of variance, and the agreement among devices was determined using Bland-Altman analyses. RESULTS: The global RNFL thickness was greatest when measured using the Topcon DRI OCT, with a mean value of 107.5 µm. The mean global RNFL thicknesses measured using the RTVue-100, RS-3000 Advance OCT, and Spectralis OCT were 104.9 ± 8.4, 104.4 ± 9.4, 102.5 ± 8.9 µm, respectively. The Cirrus HD-OCT presented the thinnest RNFL measurement, with a mean value of 97.7 ± 8.7 µm (p < 0.01). A similar pattern was found for the quadrant RNFL thicknesses (p < 0.01). Differences in the global RNFL thicknesses among the devices ranged from 0.5 to 9.9 µm. The limits of agreement of the global RNFL thicknesses evaluated by Bland-Altman analyses ranged from 6.8 to 19.6 µm. CONCLUSIONS: RNFL thicknesses measured using five different OCT devices were not interchangeable and there was a wide limit of agreement. When interpreting RNFL thickness values determined by different devices, caution is advised.

Management of Postoperative Ocular Hypotony after Tube Surgery by Stenting Using Two 5-0 Nylon Threads

No abstract available.

ERRATUM: Corrections of Figure 1 and Dose Information of Methylprednisolone: DRESS (drug reaction with eosinophilia and systemic symptom) syndrome caused by both first-line and second-line antitubercular medications: A case report with a brief literature

In this paper, some parts of Fig. 1 and dose information of methylprednisolone on page 113 were misprinted.

Implantation of a Modified Baerveldt Glaucoma Implant with a Smaller Tube and Intraluminal Stent

No abstract available.

Retinal Nerve Fiber Layer and Macular Ganglion Cell Thicknesses in Situs Inversus of Optic Discs

PURPOSE: To investigate circumpapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses as measured by optical coherence tomography in eyes with situs inversus of optic discs. METHODS: RNFL and macular GCIPL thicknesses were measured in eyes with situs inversus of optic discs without other ocular abnormalities (situs inversus group) and in age- and refractive error-matched healthy eyes (control group). RNFL thickness (global area, superior, nasal, inferior, and temporal quadrants) and GCIPL thickness (global area, superior-temporal, superior, superior-nasal, inferior-nasal, inferior, and inferior-temporal sectors and minimum) were compared between the groups. RESULTS: Nine eyes of 5 subjects with situs inversus of optic discs and 20 healthy eyes of 20 subjects (10 eyes for control groups A and B, respectively) were enrolled. No significant difference was found in superior or inferior quadrant RNFL thickness (p > 0.05); however, the situs inversus group showed a thicker RNFL in the nasal quadrant and a thinner RNFL in the temporal quadrant (p < 0.01). In macular GCIPL thickness, no significant difference was found in the superotemporal or inferiotemporal sector or for minimum thickness (p < 0.05); however, the situs inversus group showed thicker GCIPL in the global area, superior, superonasal, inferonasal, and inferior sectors than the control groups (p < 0.01). CONCLUSIONS: In eyes with situs inversus of optic discs, distribution of circumpapillary RNFL and macular GCIPL thickness were different from eyes without this condition. When assessing RNFL and macular GCIPL thicknesses in eyes with situs inversus of optic discs, caution is needed.

DRESS (drug reaction with eosinophilia and systemic symptom) syndrome caused by both first-line and second-line antitubercular medications: A case report with a brief literature review

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially fatal drug-induced systemic hypersensitivity response characterized by erythematous eruption, fever, leukocytosis with eosinophilia, and internal organ involvement. Antitubercular agents are potential causative agents for DRESS syndrome but difficult to verify as a culprit drug, since antitubercular agents are coadministered as a combination regimen. A 42-year-old female with endobronchial tuberculosis was diagnosed with DRESS syndrome after 4-week treatment of isoniazid, rifampicin, ethambutol, and pyrazinamide with prednisolone 50 mg. All the antitubercular agents were stopped and replaced with levofloxacin, cycloserine, p-aminosalicylic acid, and kanamycin. However, severe exacerbation of DRESS syndrome compelled the patient to discontinue the administration of the second-line antitubercular agents. Two months later, the patient underwent a patch test for all the antitubercular agents which had been used, and the results showed positivity to isoniazid and cycloserine. We report a rare case of DRESS syndrome that reacted to cycloserine as well as isoniazid. Development of coreactivity to other drugs should be differentiated with a flare-up reaction in the management of DRESS syndrome.

The Path to Glaucoma Diagnosis

PURPOSE: To evaluate the events leading to a diagnosis of glaucoma. METHODS: Medical records of 484 subjects (223 women, 261 men; mean age, 55.3 years) who visited a glaucoma clinic without previous glaucoma diagnosis were reviewed. Events were classified into: 1) glaucoma-related symptoms, such as ocular pain accompanied by intraocular pressure elevation or visual disturbance without other ocular abnormalities except glaucoma, 2) ocular examination by an ophthalmologist for other symptoms, 3) routine health examination, or 4) patient request due to family history of glaucoma. Ocular findings that suggested glaucoma and led to detailed glaucoma assessment were classified as: 1) an optic disc abnormality, 2) high intraocular pressure, or 3) both. RESULTS: Events that led to the diagnosis of glaucoma were glaucoma-related symptoms in 11.8%, examination by an ophthalmologist in 74.2%, routine health examination in 12.4%, and family history in 1.7% of subjects. Findings that suggested glaucoma in ocular and routine health examinations were an optic disc abnormality in 84.2% and high intraocular pressure in 15.8%; both of these findings were found in 7.4% of subjects. CONCLUSIONS: The most common path to glaucoma diagnosis was optic disc assessment by an ophthalmologist and routine health examination. To facilitate early detection of glaucoma, regular detailed optic disc evaluation by an ophthalmologist should be emphasized.

A Case of Acute Angle Closure Caused by Dislocation of Accommodative Intraocular Lens

PURPOSE: To report a case of acute angle closure after cataract surgery using an accommodative intraocular lens (IOL), WIOL-CF® (GELMED, Praha, Czech). CASE SUMMARY: A 46-year-old male patient underwent phacoemulsification and implantation of WIOL-CF® into the capsular bag. Seven months after the surgery, a sudden increase in intraocular pressure (IOP) associated with angle closure was observed. Ultrabiomicroscopy revealed a dislocated WIOL-CF® that was pushing the peripheral iris anteriorly. Despite the use of IOP-lowering medication and peripheral laser iridotomy, IOP was not controlled. After the use of cycloplegics, the angle was widened and IOP decreased; however, after nine days, the WIOL-CF® was completely dislocated into the anterior chamber and so was removed. CONCLUSIONS: When performing cataract surgery using WIOL-CF®, a possibility of dislocation of IOL and subsequent angle closure should be considered.

Peripapillary Retinoschisis in Non-Glaucomatous Eyes

PURPOSE: To investigate the characteristics of non-glaucomatous eyes with peripapillary retinoschisis. METHODS: Six non-glaucomatous eyes with peripapillary retinoschisis were enrolled. Age, sex, refractive error, intraocular pressure, location and changes of peripapillary retinoschisis, and the presence of accompanied abnormalities were assessed. To determine possible abnormalities of the optic nerve head and macula, fundus photographs and cross-sectional images of the optic nerve head and macula obtained by optical coherence tomography were inspected. RESULTS: Three males and 3 females were enrolled. Age of the subjects ranged from 11 to 59 years (median, 45 years). Refractive error ranged from -6.25 to +1.00 diopter (median, -0.50 diopter). Peripapillary retinoschisis was located in the superior quadrant in four eyes, in the nasal quadrant in one eye, and in the inferior quadrant in one eye, respectively. No additional abnormalities were found in fundus photographs or in the cross-sectional images of the optic nerve head and macula that were obtained by optical coherence tomography. Longitudinal follow-up was available for two eyes and spontaneous resolution of peripapillary retinoschisis was observed in these eyes 6 and 9 months later, respectively. CONCLUSIONS: Peripapillary retinoschisis was observed in non-glaucomatous eyes. This finding was observed in subjects of various ranges of age and refractive error, and in both sexes, without any other accompanying abnormalities.

Assessment of Glaucoma Medication Compliance

PURPOSE: To assess glaucoma medication compliance and its causative factors in glaucoma patients. METHODS: This study was performed via a structured questionnaire given to 415 glaucoma patients using eye drops for glaucoma treatment. The degree of compliance was evaluated by using compliance score (range, 0-100) which was calculated based on the number of days of missing medication per month. The degree of symptoms and complications related to glaucoma and its medication were investigated using the Glaucoma Symptom Scale (GSS). The effect of sex, age, treatment duration, knowledge about the glaucoma medication, number of eye drops, class of glaucoma medication, family support for eye drop use, and GSS on glaucoma medication compliance was assessed. RESULTS: The most frequently found number of days of missing medication per month was one to four (43.4%). The most common reason for missing medication was forgetfulness (80.5%), followed by busy daily schedule (18.4%) and complications of medication (1.1%). Compliance score ranged from 10.0 to 100.0 (median value, 90.0). Older age, longer duration of treatment, higher knowledge about the glaucoma medication, and the presence of family support was significantly associated with a higher compliance score (p < 0.05). Sex, number and class of eye drops, and GSS did not significantly affect compliance score. CONCLUSIONS: Age, treatment duration, knowledge about the glaucoma medication, and familial support were affecting factors for glaucoma medication compliance. To enhance glaucoma medication compliance, these factors should be considered.