Ineffective self-installation of eye drops was linked to a higher long-term risk of progression or progression to incisional surgery in patients with glaucoma or ocular hypertension. For a study, the researchers sought to find a link between self-installation of eye drops and long-term glaucoma results. In a prior study, video recordings of glaucoma or ocular hypertension patients’ self-instilling eye drops were assessed as effective or ineffective based on whether the patient successfully instilled at least 1 drop on the suitable ocular surface. Glaucoma progression was then defined as thinning of the retinal nerve fiber layer as measured by optical coherence tomography, visual field progression, or the need for incisional glaucoma surgery as determined by a glaucoma specialist who was not aware of the patient’s performance in the eye drop instillation study. The study comprised subjects who had at least 2 follow-up optical coherence tomography or visual field examinations. A total of 119 patients were enrolled in the original research. For 101 patients, sufficient follow-up data was available. At baseline, 88 patients (87.1%) successfully instilled ocular drops. However, 73 patients (72.3%) developed progression or underwent incisional surgery in either eye over the 5.1-year follow-up period. In the ineffective group, a considerably higher number of patients satisfied progression criteria or required incisional surgery (effective: 68.2%; ineffective: 100%; N=101; P=0.017, Fisher exact test). In the weak group, Kaplan-Meier survival studies revealed a considerably shorter time to reach an endpoint (N=101; P=0.012, log-rank test). There was no difference between the groups regarding age, baseline intraocular pressure, or baseline retinal nerve fiber layer thickness. Self-application of ineffective eye drops was linked to an increased likelihood of glaucoma development or treatment progression to incisional surgery.