الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Glaucoma is the second leading cause of blindness in the world according to the World Health Organization. Also In Africa Studies highlighted that primary open angle glaucoma is the second leading cause of blindness ,POAG has an early onset and progress more rapidly than in Caucasians.
While there are multiple methods for treatment of glaucoma, medical therapy is still the mainstay of therapy, especially early in the disease course. Lack of adherence with treatment and dosing can lead to persistent elevation or fluctuations of intraocular pressure (IOP), which has been shown to be a risk factor for glaucomatous progression. Therefore, improving patients’ adherence to therapy is of the almost importance.
The methods available for measuring adherence could be classified into direct and indirect methods of measurement. Each method has advantages and disadvantages, and no method is considered the gold standard.
Direct approaches are expensive, burdensome to the health care provider, and susceptible to distortion by the patient. Indirect methods of measurement of compliance include asking the patient, assessing clinical response, ascertaining rates of refilling prescriptions, collecting patient questionnaires, using electronic medication monitors, measuring physiologic markers on multiple occasions have been used. Although certain methods of measuring compliance may be preferred in specific clinical or research settings, a combination of measures maximizes accuracy
There are many reasons for patients to be medication non adherent. Some of these include cost of medications, inability to dose the medications themselves, side effects, and failure to understand the role of medical therapy in the treatment of their disease, low income ,not understanding the goal of medication well ,feeling no hazards from discontinuation of medications ,miscommunications between patient and his ophthalmologist ,lack of knowledge about glaucoma ,co morbidities and difficulties in using medications for glaucoma due to different causes. However, the most common reason is patient forgetfulness. Unfortunately, in a disease such as Primary Open Angle Glaucoma, the motivation to take drops may be low because the patient typically has no pain or other symptoms that would motivate the patient to take his medication.
Patient education about the need for the medication and how to use it, and equally important to take the time to make sure the patient understands the handling and administration of the drops as well as what results to expect. Using different methods to help the patient can improve the medication adherence. .
Minimizing dose frequency and the use of less number of eye drops or use combinations when possible can help patients who are taking many medications every day.
Learning Glaucoma patients about the proper eye drops instillation technique also should be done and should be helpful for proper dosing and using of the medications.
In the current study, the questionnaire was the chosen method of evaluating the adherence level in a randomly chosen 100 Egyptian POAG patients, and the following had been dedicated:
In this sample, the adherence level was 67%. Forgetfulness was the main adherence barrier
Being old age with low income will passively affect the adherence level. Less frequently used topical eye drops with fewer side effects should be used
Most patients reported no instillation difficulties; they also reported that this was the first time they had been asked about the maneuver of their eye drops instillation. What indicates the importance of learning the patient about his medication and method of administration and improving the patient –doctor relationship, and make sure that every patient instills his eye DROP properly.