RETROSPECTIVE STUDY

Glaucoma is a group of degenerative diseases of the optic nerve, and it is a major cause of irreversible blindness. Glaucoma treatment and management rely on effective prescription patterns and proper medication adherence. In Nigeria, differences in the prescription patterns and poor medication adherenceremain barriers to optimal glaucoma management. This study retrospectively assessed prescription patterns and patient adherence to anti-glaucoma medications at Metroeyes Clinic, Ikoyi, Lagos, from January 2021 to December 2024, reviewing 107 patient case files. Prescription patterns were accessed by extracting data from clinical records of selected patients. The level of Adherence was assessed using the Medication Adherence Scale-12 (MAS-12) through structured phone interviews, and the data were analysed with descriptive statistics, Chi-square tests, and logistic regression using SPSS version 27. The analysis results showed that prostaglandin analogs (59.5%) were the most commonly prescribed class of drugs, followed by fixed combination therapies (41.1%). Monotherapy was prescribed frequently than combination therapy, and most patients were given night-time (nocte) prescriptions (67.3%). Despite these rational prescription patterns, poor adherence was alarmingly high: 65.4% of patients were non-adherent, 29.9% were moderately adherent, and only were 4.7% fully adherent. The major reasons recorded for non- adherence included forgetfulness, dislike for long-term use of drugs, and perceived lack of necessity. There was no significant association found between prescription patterns and the adherence levels (p > 0.05), which is most likely due to the small number of adherent patients. In Summary, whereas the prescribing patterns at Metroeyes Clinic aligned with international standards and best practices, adherence remained alarmingly low. Rational prescribing alone has been proven insufficient to improve management outcomes. Therefore, future interventions should emphasize patient education on drugs, reminder systems, patient purchasing power, and psychological support. Strengthening these areas can improve medication adherence and reduce blindness attributable to glaucoma in Nigeria and across Africa.