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Background/aims: This study aimed to investigate treatment patterns and medication adherence of glaucoma. It also identified key factors associated with non-adherence. Methods: It was a cross-sectional, observational study. Patients who use eye-drops for =2 years were recruited at 15 eye clinics from March to November 2013. Data were collected through self-administered questionnaires and medical chart review. Medication adherence was evaluated using patients' self-report on pill count and defined as patients' administering drug for =80% of prescribed days. Medication adherence rate was calculated by dividing actual number of administration from total prescribed number of administration for 7 days. Patients whose self-reported prescription was different from total daily doses of physicians' prescription were considered as non-adherent. Results: A total of 1050 patients included, and medication adherence rate was evaluated in 1046 patients whose verification of adherence was available. Of the total, 27.4% were non-adherent, and the medication adherence rates of the total, the adherent, and the non-adherent were 90.6±17.8%, 96.8±5.5% and 56.6±24.7%, respectively. The most commonly used medication was prostaglandin (PGA) alone and the second was combination of two-class (ß-blocker and carbonic anhydrase inhibitor (CAI)) and three-class combination of PGA, ß-blocker and CAI followed. In multivariate analysis, the risk of non-adherence was 1.466 times greater in males than in females (95% CI 1.106 to 1.943) and 1.328-fold greater as the daily number of administration was increased (95% CI 1.186 to 1.487). Conclusion: Approximately, one-third of the patients were non-adherent, and males and increased daily number of administration were associated with nonadherence. It highlights that more systematic treatment strategies should be considered for better medication adherence, leading to effective glaucoma management. [ABSTRACT FROM AUTHOR]