Patient Preferences and Understanding of Glaucoma Treatment: A Nationwide Survey by the French Glaucoma Society

Introduction: Glaucoma treatment predominantly involves the use of topical anti-glaucoma eye drops, with patient adherence influenced by individual preferences. This study aimed to assess these preferences and highlight the importance of personalized treatment approaches among ophthalmologists. Methods: This French multicenter, cross-sectional study involved 21 ophthalmologists—members of the Board of Directors of the French Society of Glaucoma—from both public and private practices, who distributed a standardized questionnaire to their patients with glaucoma. The questionnaire collected data on demographics, treatment-related experiences, patient preferences, and the prioritization of six treatment criteria: cost, efficacy, dosing frequency, side effects, environmental impact, and ease of use. Results: A total of 798 patients with glaucoma participated. There was no strong preference between multi-dose bottles and single-dose units (32.0% vs. 37.4%, respectively, with 29.2% of patients showing no preference). Side effects were reported by 31.8% of patients, and the use of artificial tears was significantly higher among those with longer treatment durations (31.3% for ≤ 2 years vs. 65.6% for > 20 years, p = 0.001). Notably, 63% of patients were unaware that their eye drops could contain preservatives. Regarding generics, 29.9% of patients had previously used one, while only 25.6% were willing to switch from their prescribed brand to a generic equivalent. Adherence was suboptimal, with only 66.2% of patients reporting being compliant. Younger age (p < 0.001) and lack of awareness about preservatives (p < 0.001) were significantly associated with non-adherence. When ranking treatment criteria, patients prioritized efficacy, followed by side effects, ease of use, cost, and environmental impact. Conclusion: This nationwide survey conducted by the French Glaucoma Society underscores the diversity of patient preferences and the critical need for personalized glaucoma care. A substantial proportion of patients feels insufficiently informed about preservatives and generics, which may negatively impact adherence. Enhanced patient education and individualized treatment strategies are essential for improving outcomes.