Objective: To analyze the related factors of health-related quality of life (HRQOL) after surgical treatment with glaucoma patients. Methods: A prospective cohort study was conducted in 86 patients with glaucoma diagnosed between February 2014 and December 2017. All patients completed 3 HRQOL questionnaires: 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ25), Chinses Adult Strabismus Questionnaire (CAS-20) and Diplopia Questionnaire (DQ) survey. Of the 86 patients, 37 received trabeculectomy, and the remaining 49 received medical treatment. Multiple regression analysis and HRQOL related factors included gender, age, treatment modalities, visual field, vision and diplopia on the decline of HRQOL. Results: Of the 86 patients, there were 35 men and 51 (59%) women; the average age of the patients was (65±10) years, and the mean deviation (MD) of the visual field was −13 (10) dB. The poor HRQOL was related with severe diplopia [partial r² range (r_p²), 0.207–0.069], lower best-eye MD (r_p² range, 0.379–0.027), lower worst-eye MD (r_p² range, 0.242–0.046), treatment group (r_p² range, 0.190–0.025), lower worst-eye visual acuity (r_p² range, 0.063–0.025), lower best-eye visual acuity (r_p² range, 0.032–0.017) and early onset age (r_p² range, 0.021–0.014). In adjusted analyses, the score of the CAS-20 scale suggested that compared with medication, trabeculectomy would lead to a poorer HRQOL. Conclusion: This study suggests that poor HRQOL is very common in glaucoma patients, whether undergoing surgery or medication. In general, the decrease of HRQOL in glaucoma patients is associated with more severe diplopia, lower visual average deviation, poor binocular vision, treatment and early onset age. Compared with drug therapy, trabeculectomy is particularly related to the poorer HRQOL. The choice of surgical methods in clinical practice should be carefully considered.