OBJECTIVES: Develop a health economic model to measure the standard of care costs in the United Kingdom (UK) associated with progression of primary open angle glaucoma. METHODS: We used Monte Carlo techniques to model the cost of a simulated cohort of 600 patients with Mean Deviation (MD) score progression over four years. MD scores were used to estimate resource utilization for the cohort using regression equations from an analysis of the relationship between resources and MD score in the worst eye from a European chart review of glaucoma patients (N = 194 from UK, Italy, France, Germany and Austria). Both medical (number of office visits, visual field exams, trabeculoplasties and trabeculectomies) and pharmacy resources (number of glaucoma medications) were included in the model. UK NHS reference costs were applied to the medical resource utilization estimates; medication costs from the British National Formulary were applied to the pharmacy utilization estimates. MD scores were also used to predict utility scores based on a regression analysis of utility scores among glaucoma patients in Sweden; the quality-adjusted-life years (QALYs) over four years was modeled. A probabilistic sensitivity analysis was also performed. RESULTS: The four-year cost for the cohort was £932 per patient (£196 in pharmacy costs and £736 in medical costs) with 2.96 QALYs accumulated over four years. CONCLUSION: Glaucoma progression as evidenced by worsening MD scores is associated with a loss in quality of life and substantial costs over four years of follow-up. Managing the disease and delaying progression has the potential to improve quality of life and reduce costs among patients with progression.