Once diagnosed, the glaucoma patient requires lifelong treatment, usually with topical IOP lowering medication. The aim of glaucoma treatment is to reduce IOP, a ‘clinician-based’ measure, and thus treatment has no obvious effect on the patient’s vision or their ability to carry out every-day tasks. There is evidence to suggest that medication underuse occurs in patients with glaucoma. Deliberate medication underuse occurs when the patient is concerned with aspects relating to either the treatment safety, or treatment efficacy and necessity. In glaucoma, medication misuse may lead to inappropriate conclusions regarding treatment inefficacy, resulting in unnecessary changes and additions to treatment, and, more seriously, avoidable, irreversible visual loss. Improving patient adherence to their treatment is a complex issue influenced by a number of factors. This talk will explore some of the issues regarding glaucoma medication misuse and the role of the ‘doctor-patient’ relationship in promoting adherence to treatment.