OBJECTIVES: The objective of this analysis was to estimate the total budget dedicated to glaucoma care according to the UKGPRD and to identify factors associated with high costs. METHODS: Data were extracted on patients treated on the National Health Service with a diagnosis of ocular hypertension or glaucoma, or treated with topical intraocular lowering treatment, surgery or laser for glaucoma.  The budget was estimated from resources consumed in 2008 and included glaucoma drugs, laser, surgery, hospitalization, specialist and general practitioner (GP) visits. In-patient resources were estimated from the Hospital Episode Statistics. Results were expressed in GBP, 2008. Factors associated with high cost were identified using  linear stepwise regression. National extrapolation was performed according to the relative size of the GPRD to the UK general populations. RESULTS: Details of 33,441 patients were extracted, which suggests that about 510,000 patients were treated in the NHS in UK in 2008. The Mean age was 74.2 years, and 47.3% were male. The initial diagnosis was made at 67.8 years. Older patients, longer time since diagnosis, a higher number of previous treatments, a higher number of treatment switches in the previous one year period and use of laser / surgery were associated with a higher annual cost. Spending varied little between regions. Annual drug spending was £91.2 million on in-patient care, £4.4 million on drug prescription renewal (not specific to the glaucoma drug).   Visits to the GP cost £34.8 million and visits to the eye specialist was > £54.0 million although the latter figure is likely to be an under estimate (GPRD underreported eye doctor care). CONCLUSIONS: The 2008 expenditures to care for glaucoma were > £185 million with no regional differences. Three factors were strongly associated with high costs: time since diagnosis, treatment changes, and rescue treatment. This analysis suggests that longer treatment persistence is likely to be associated with cost saving.