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Prcis: This study demonstrated that the compliance levels with International Council of Ophthalmology (ICO) Guidelines for glaucoma eye care were low for all the elements in both public and private health care settings., Purpose: To determine the compliance with the ICO guidelines for glaucoma eye care among Pakistani ophthalmologists and to compare differences among ophthalmologists practicing in public and private health care settings., Materials and Methods: This was a retrospective chart review, and the records were reviewed according to ICO guidelines. The ICO recommends that each patient with glaucoma be evaluated for 19 items from 3 elements which are history, examination, and investigations. Mean compliance was recorded for each of the 3 elements. The compliance of each item was also checked and then a compared between the 2 settings, that is, public and private health care settings., Results: A total of 394 records were analyzed, with a mean age of 51.9±14.9 years and 232 (58.9%) male patients. Most records were from private settings 339 (86%), and primary open angle glaucoma 163 (41.4%) was the most common diagnosis. Compliance was low for all elements; history (31.8%), examination (61.3%), and investigation (6%). Pupil reaction differed significantly between the 2 groups ( P =0.001)., Conclusion: Pakistan's ophthalmologists, whether in public or private health care settings, lack knowledge of ICO guidelines for glaucoma eye care. This study emphasizes the importance of implementing these guidelines in the general ophthalmology curriculum., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)