Background: European studies have identified primary open angle glaucoma (POAG) as the second leading cause of blindness, accounting for 8-10% of blindness in older people. The objective of this study was to estimate the societal costs and the quality of life among patients with late stage POAG. METHODS: Charts of late stage POAG patients in France, Germany, the UK and Denmark were reviewed and the patients were interviewed. Costs and utility values of health related quality of life were estimated (based on resource use multiplied with unit costs and on EQ-5D questionnaire). RESULTS: 162 patients were included. Average level of visual acuity was 0.28 and 0.11 of the best and worst eye, respectively. Annual health maintenance costs of late stage glaucoma patients are €830 (SD: €445). This does not include costs of surgery and larger procedures. Purchase costs of devices amount to €2045 per patient. Most importantly, however, are costs of home care, which average €2703 per year. With respect to the health related quality of life the average score is 0.67 and best predictor of QoL is visual acuity of the patients' best eye (negatively correlated, p=0.005). Best eye visual acuity is also negatively correlated with health care maintenance costs (p=0.024). With respect to home care costs the correlation is positive but not significant. CONCLUSION: This study shows that late stage glaucoma is associated with considerable health care and – in particular – social care costs (home care). It is an important finding that maintenance health care costs is negatively correlated with visual acuity (and thereby QoL). A lower visual acuity is predictive of lower QoL.