To assess adherence patterns to the UK National Institute of Health and Clinical Excellence(NICE)guidelines on Primary COAG diagnosis and Management(2017)in glaucoma clinics of a Palestinian Eye Hospital.  Method The audit was designed on randomly selected 64 primary chronic open-angle glaucoma patients from a glaucoma clinic of the eye hospital-Palestine, who fulfilled the inclusion criteria. Patients were divided into two groups (New and Follow up groups), then 32 patients were randomly selected from each group. Data were collected retrospectively from patients' medical records. The main outcome measures were compliance with six of the main NICE guidelines on glaucoma diagnosis and management (November 2017).  Results Glaucoma clinics showed poor adherence to guidelines regarding obtaining most of the initial assessment investigations (central corneal thickness gonioscopy visual field testing, and optic nerve image , the choice of initial treatment , arranging appropriate monitoring intervals whether compliance with treatment was checked (6%). However, full adherence (100%) was seen in obtaining applanation tonometry and disc assessment at the initial assessment. In general, both patient groups’ results show poor adherence to NICEguidelines and generalization of the clinical practice to most patients with restricted tests and plans that have been performed and generalized. No clear or definite local or global guideline is followed in the practice. Therefore, appropriate policy changes and programs to increase awareness of NICE guidelines are recommended to improve the quality of care for glaucoma patients and a professional performance. Re-audit should be designed after one year of implementing the recommended changes and improvements.

Keywords : Primary Chronic Open-Angle Glaucoma, Diagnosis, Management, Guidelines, Clinical Audit.