Reasons for delay to diagnosis. Listed in rank order (n=97)
| Theme | Subtheme | Quote |
| Delay due to lack of appointments, facilities or staff (n=45/97) (wet=29, dry=9, not specified=7) | Delay getting appointment with HCP (n=39) Delay getting appointment due to lack of facilities (n=6) | (w)‘My GP referred me to an eye specialist but my appointment was not for 6 weeks’ #1133 (d)‘waited for appointment with consultant at Royal Eye Infirmary…’ #474 (w)‘Optician had no scanner (I think) & immediately sent his suspicions up to our crowded- RSCH, with a personal note.’ #1506 (w)‘It was Easter+I did not think to go to a hospital on a Sunday’ #1009 |
| AMD was not detected/labelled in the initial consultation (n=30/97) (wet=14, dry=13, not specified=3) | Wait and see approach to symptoms (n=2) HCP did not detect/label AMD in initial consultation (n=20) AMD not spotted until cataract removal (n=8) | (d)‘thought I was imagining the impairment?’ #1269 (d)‘for 2 years at routine annual check-ups I told the young women I thought I had blind spots… the next year I made a list of symptoms and gave it to the optician, an older more experienced man.’ #818 (w)‘The optician at Specsavers told me I had cataracts and sent me home to get worse and I got a lot worse v quickly…’#48 (w)‘not until cataract removed that diagnosed with MD’#13 |
| Patient did not attribute symptoms to AMD (n=20/97) (wet=14, dry=5, not specified=1) | Patient lacked knowledge about symptoms of AMD (n=4) Patient attributed symptoms to another eye problem (n=15) Patient lacked knowledge of perceived risk for developing AMD (n=1) | (w)‘I was not aware of Macular conditions affecting eyes…’#1102 (w)‘I thought that perhaps I had scratched the eye or similar’ #28 (d)‘thought I just needed stronger glasses’.#870 (w)’I had heard of AMD… thought it only affected people older than myself’#995 |
| Referral delay due to being passed between HCPs (n=17/97) (wet=13, dry=2, not specified=2) | Being passed between HCPs (n=17) | (w)‘two months later I saw my GP who referred me back to the optician and the hospital’#315 (d)‘told by optician would send letter to doctors & up to them if they referred or not to hospital’ #669 |
| Patient did not perceive symptoms as urgent or important (n=13/97) (wet=7, dry=3, not specified=3) | Patient didn't realise urgency of early help seeking for symptoms (n=4) Patient didn’t perceive seriousness/ importance of symptoms (n=9) | (d)‘I had a regular yearly eye appt due a few weeks ahead’#1144 (w)’church steeples were crooked for some time but it was moving white lines in road when driving that made me seek help’#51 (w)‘I didn’t realise it could be serious and thought I (would) just check at the opticians’ #571 (d)‘did not think it important’ #987 |
| Patient unavailable to make early appointment due to personal reasons (n=11/97) (wet=9, dry=1, not specified=1) | Patient was busy/unavailable to book early appointment (n=8) Other health conditions/family health took precedence (n=3) | (w)‘I was on holiday in 2009 in Scotland, when discomfort started…’ #605 (w)‘Also I had quite serious health problems at the same time (Heart+Thyroid/overactive)’ #1102 (d)‘my husband was ill, he needed me as I was his full time carer…’ #1396 |
| Patient told ‘nothing can be done’(n=8/97) (wet=2, dry=4, not specified=2) | HCP said nothing can be done (n=5) HCP told patient to monitor their eyes/make an appointment (n=3) | (d)‘I have never had an appointment with the … clinic, I have been refused and told there is nothing they can do’. #1063 (w)‘…told that I had not been referred to the hospital… although the optician had in fact recognised wet AMD “because of the data protection act”’#48 (n/s)‘…and had not been told to do anything but to look at a card regularly in case it got worse’ #60 |
| HCP did not perceive AMD symptoms as urgent (n=7/97) (wet=4, not specified=3) | HCP did not realise/stress urgency of early help seeking for AMD symptoms | (w)‘The optician said I only had slight signs of MD- not to worry as it was normal at my age’ #1076 |
| Delay getting appointment due to issues with correspondence (n=6/97) (wet=5, not specified=1) | (w)‘I did not see a specialist for 10 weeks…letters getting “lost” in the system’ #81 (w)‘I did not receive an appt at the eye clinic for four weeks as they had sent my appt to the wrong address’ #732 |
#number= respondent ID code.
This table includes the themes cited by ≥6 respondents.
(d), respondent with dry AMD; (n/s), not specified; (w), respondent with wet AMD.