AIM To describe the clinical presentation of ocular surface disease in primary open angle glaucoma patients using topical anti-glaucoma medications in Eye Foundation Hospital, Lagos. METHODS A hospital based case control study carried out among three hundred and fifty patients who met the eligibility criteria. One hundred and seventy five glaucoma patients using topical anti glaucoma medications for at least six months were compared with one hundred and seventy five age and sex matched non glaucoma patients not using any topical medications who served as controls. Informed consent was obtained from each participant after ethical approval had been obtained from Health Research and Ethics Committee. Each patient completed an Ocular Surface Disease Index (OSDI) questionnaire to elicit the extent of ocular surface disease symptoms. Demographics, ocular history and information on use of anti-glaucoma medications were also collected. They all had slit lamp anterior segment examination and objective assessment of ocular surface disease (OSD) using tear film break-up time, corneal and conjunctival staining with fluorescein and lissamine green stains and Schirmer test. Data obtained was analyzed using Statistical Software for Social Sciences V16.