Table 3

Reasons for delay to diagnosis. Listed in rank order (n=97)

Delay due to lack of appointments, facilities or staff
(wet=29, dry=9, not specified=7)
Delay getting appointment with HCP
Delay getting appointment due to lack of facilities
(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
(wet=14, dry=13, not specified=3)
Wait and see approach to symptoms

HCP did not detect/label AMD in initial consultation

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
(wet=14, dry=5, not specified=1)
Patient lacked knowledge about symptoms of AMD
Patient attributed symptoms to another eye problem
Patient lacked knowledge of perceived risk for developing AMD
(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
(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
(wet=7, dry=3, not specified=3)
Patient didn't realise urgency of early help seeking for symptoms
Patient didn’t perceive seriousness/ importance of symptoms
(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
(wet=9, dry=1, not specified=1)
Patient was busy/unavailable to book early appointment
Other health conditions/family health took precedence
(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

HCP told patient to monitor their eyes/make an appointment
(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
(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
(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.