Objective: Adaptive coping mechanisms (ACMs) are effective ways to cope with stress and anxiety in patients with chronic illnesses, such as glaucoma. This study aimed to assess the proportion of ACM and associated factors among adult glaucoma patients enrolled at the tertiary eye care and training centre in Northwest Ethiopia.

Methods: An institution-based cross-sectional study. Methods: This study was conducted at a tertiary eye care and training centre in Northwest Ethiopia from 15 May 2022 to 30 June 2022. Methods: The study included a sample of 398 adult glaucoma patients selected using a systematic random sampling technique. Methods: The participants were diagnosed with glaucoma by ophthalmologists. Optometrists conducted interviews, reviewed medical records and administered a pretested, structured questionnaire based on the Brief Coping Orientation to Problems Experienced inventory. Binary logistic regression was performed to identify associated factors, with significance considered at a p<0.05 and 95% CI.

Results: The prevalence of ACM use among glaucoma patients was 45.7% (95% CI 41.2% to 50.3%). Factors significantly associated with ACM included urban residence (adjusted OR, AOR 2.57, 95% CI 1.25 to 5.28), higher average family monthly income (AOR 3.83, 95% CI 1.37 to 10.70), moderate to severe visual impairment (AOR 2.24, 95% CI 1.06 to 4.74), duration of diagnosis between 11 and 16 months (AOR 3.94, 95% CI 1.84 to 8.44) and more than 24 months (AOR 3.75, 95% CI 1.59 to 8.81) and the presence of ocular comorbidities (AOR 4.28, 95% CI 2.28 to 8.05).

Conclusions: About half of adult glaucoma patients used ACM to manage their condition. Older age, urban residence, higher average family monthly income, moderate to severe visual impairment and the presence of ocular comorbidities were significantly associated with ACM. Implementing an integrated approach that incorporates biopsychosocial strategies aimed at reducing ACM and promoting the adaptive one is essential.