There is a large body of evidence from clinical and experimental studies that the long-term use of topical drugs may induce inflammatory ocular surface changes. The high prevalence of symptoms and signs of ocular surface disease (OSD) in patients with glaucoma or OHT has been demonstrated in several clinical studies. In parallel, inflammatory changes of the ocular surface directly impact the effectiveness of antiglaucoma medical and surgical treatments. Ocular surface side effects impact the quality of life and are significant barrier to adherence in patients treated for glaucoma or ocular hypertension. Moreover, as conjunctival wound healing is a major determinant for the success of glaucoma filtering surgery, ocular surface inflammation is a well-known risk factor for surgery failure by subconjunctival fibrosis. Therefore, a better knowledge of ocular surface inflammatory changes with appropriate evaluation and management should thus become a new paradigm in glaucoma care.