Primary open-angle glaucoma (POAG) is among the most common causes of irreversible loss of visual functions, its early diagnosis and treatment present great difficulties. POAG development involves many mechanical, hemodynamic and metabolic factors. The main approach to its treatment is reduction and normalization of the intraocular pressure (IOP), starting with local antihypertensive therapy. But since glaucoma requires life-long management, lengthy topical therapy can itself become the cause of many serious issues. Most often, they include achieving consistent normalization of IOP, systemic and local adverse events, difficulties with patient compliance, decreased quality of life, increased risks of the glaucoma surgeries. Ophthalmological practice and research continue to demonstrate the need for changing the paradigm of POAG treatment.