Table 3

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

ThemeSubthemeQuote
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.