AMD Services have continued to expand following the introduction of contemporary treatments for AMD. The workload associated with such contemporary AMD services is significant and will continue to increase as it is agreed that despite pro re nata (PRN) treatment with ranibizumab, best outcomes are achieved with monthly follow-up visits. It is expected that these follow-up visits may continue for as long as four years. The staffing of these clinics, including medical, in some departments is well below the expected levels. This was shown in the recent College Survey. Some eye departments have been unable to recruit medical staff especially middle grade doctors, either because of inadequate funding of services or inability to recruit to the correct specification. The pressure on resources and service delivery in the AMD clinics will become even more intense as we are unable to discharge patients in the system, but have to accommodate all the new ones. The regular monthly follow up for AMD patients under treatment in order to maintain efficacy is quite demanding. This situation is likely to be further aggravated by the impending treatments of retinal vein occlusions and some diabetic retinopathies with intravitreal therapies. As such the problem seems more acute than was originally envisaged, and will get worse.