OBJECTIVES: To investigate the burden and epidemiology of glaucoma in a large health maintenance organization (HMO) in Israel. METHODS: A retrospective cohort study, conducted using the electronic medical databases of Maccabi Healthcare Services (MHS), a 2 million member HMO in Israel. The study population consisted of all patients who were newly diagnosed with glaucoma between 2003 and 2010 at MHS. In addition, for prevalence calculation we included all patients who are currently (2012) active members of MHS. Collected data included personal characteristic, relevant surgical procedures, anti-glaucoma medications, caregiver characteristics, comorbidity, possible complications (asthma, depression, cardiovascular diseases, cataract) and all-cause mortality. We investigated the age- and sex-specific prevalence and incidence rates, and compared the medical comorbidity and mortality of glaucoma patients to the general HMO population. RESULTS:  A total of 26,196 prevalent glaucoma patients aged 40 or above were identified among active members of MHS in 2012 with an average prevalence of 35 per 1000. Prevalence was strongly associated with increasing age, ranging from 7 cases per 1000 at age 45-50 to 212 per 1000 at age 85+. The 4 main prevalent pathologies among MHS population aged 40 or above were open angle glaucoma, pre or borderline glaucoma, unspecified glaucoma, and pseudo exfoliation with prevalence rates of 2%, 1.4%, 0.9% and 0.2%, respectively. A total of 11,512 incident glaucoma patients, who were diagnosed between 2003 and 2010 were identified, with an average incidence of 2.5 per 1000 among 40+ year old members. Overall, 1.5% of the study patients have undergone glaucoma surgery, 3% were blind and 41% were diagnosed with cataract. CONCLUSIONS:  The current study demonstrates the potential use of automated medical databases to estimate the burden of glaucoma and its complications. The increased comorbidity and mortality among these patients has important implication for health authorities for prevention and delivery of health-care services.