The RCOphth has recently updated its guidance on suggested waiting times for IVT treatment in nvAMD in the hospital setting. It recommends that all patients should be seen by a retinal specialist within 1 week of primary care referral, and should begin treatment within 1 week following this.14 The new guidelines place increased importance on correct diagnosis and urgent referral from primary care and place increasing emphasis on hospital eye services to provide capacity for urgent new AMD cases in addition to the treatment of existing patients with nvAMD. However, this study finds that there are significant delays at each step of the nvAMD care pathway in south-east Scotland; both the waiting times from: (1) primary care referral to ophthalmic clinic and (2) initial ophthalmic assessment to treatment are about four times as long as the recommended gold standard. In addition, there is a further 1-week delay on average when indirect referrals are made by optometrists via GP. Similar findings have also been reported in previous studies which have demonstrated similar, if not longer, delays for intrahospital pathways (ie, from initial ophthalmic assessment to treatment).10 11 16