Purpose To examine the neuroprotective action of citicoline in the treatment of glaucoma and glaucoma phacoemulsified patients. Methods Fifty‐nine patients (118 eyes) with glaucoma were included in the study. Intraocular pressure (IOP) level <25 mmHg with or without treatment was the inclusion criterion. Thirty‐three patients received citicoline eye drops three times per day for 3 months and 26 received hyaluronic Na eyedrops, respectively. During the 3 months study all the patients underwent pachymetry and repeatedly IOP measurements, Visual Field Tests (VFT), Schirmer’s tests and OCT examination. Statistical analyses performed between the two groups, including further parameters, such as the severity of IOP, the visual field defects (MD value) and the presence of IOL. Results In patients with IOP < 15 mmHg, the citicoline group (n = 14) showed improved PSD value compared to hyaluronic Na group (n = 12; p = 0.003). In the 15–20 mmHg IOP patients, no changes noticed. In patients with 20 mmHg< IOP < 25 mmHg, the citicoline group (n = 10) showed higher RNFL (94.3 ± 11.2 μm) compared to hyaluronic Na group (n = 11, RNFL = 83.2 ± 11.7 μm; p = 0.029). In 16 eyes of the citicoline group, the RNFL appeared improved in the IOL eyes (p = 0.026).There were no statistical differences between the two groups regarding the severity of glaucoma, using the MD index in VFT. Conclusion Citicoline seems to act advantageously towards the RNFL index in the IOP > 20 mmHg and phacoemulsified patients, as well as the PSD index in patients with IOP < 15 mmHg.