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Subspecialties Professional Development, Education and Training, Basic & Translational Research

Publishing in Ophthalmology: Why the Delay?

Marko Popovic, Jonathan Micieli, and Arjan Dhoot

The research publication process can be confusing, arduous, and time consuming. To complicate matters, the peer review process varies from journal to journal. We’ve always wondered, why does it take so long to receive a decision – even if it’s a rejection? Can we predict this delay?

We provided comprehensive data on journal time to publication, which could serve as a guide for prospective authors, especially those who have tight timelines for publication.

In a recent study, we investigated the factors that affect time to publication across a diverse set of ophthalmology journals (1). Using the Web of Science Journal Citation Report, we compiled a list of ophthalmology journals and closely evaluated the published articles of these journals – determining the time from submission to acceptance, and acceptance to publication, for either electronic or print publications. We also conducted a univariable linear regression model to analyze predictors of these outcomes. In total, 8,835 articles from 56 journals were included.

Overall, we found that there were significant relationships between a reduced time from submission to electronic publication and i) an increased five-year journal impact factor, ii) increased article influence score, iii) increased number of authors, iv) decreased citing half-life, and v) an increased proportion of articles having multi-institutional status. There was also a significantly reduced time to publication in hybrid journals that offer both subscription or open access options, compared with subscription-based journals.

We provided comprehensive data on journal time to publication, which could serve as a guide for prospective authors, especially those who have tight timelines for publication. Our key conclusion was that high impact factor journals have faster publication times, typically because of more available reviewers and editorial staff, and a lower likelihood of acceptance. Lower impact factor journals are slower to publish with a greater likelihood of acceptance.

The review of editorial style, such as word count and reference formatting, may add delays.

Why the delay? We believe an inability to find suitable reviewers, waiting on peer review, and logistical challenges when preparing a manuscript for publication are the likely culprits. Moreover, the review of editorial style, such as word count and reference formatting, may add delays before the scientific content is even considered.

Once an article is accepted, most journals have an acceptable time to electronic publication (median across journals = 32 days, approximately 1 month). Following electronic publication, print publication delays may occur as journals wait for a full issue to be filled.

In our view, journals could reduce the time to publication by rejecting non-suitable articles early,  providing clear style recommendations for authors, improving access to peer reviewers, and refraining from excessively focusing on editorial style before scientific content is reviewed.

Notably, the time to publication appears to be an important marker of a journal’s quality. Importantly, a slow publication process could delay the dissemination of important findings. Nevertheless, a high-quality peer-review process should remain the primary goal of journal editorial teams. Recent examples during the COVID-19 pandemic showed us how harm and mistrust could ensue when quality is sacrificed for rapid publication, leading to multiple recent retractions from top medical journals (2, 3, 4, 5).

We hope our study empowers authors to make informed decisions when submitting their manuscripts and provides journals with ideas to improve and streamline their peer review and publication process.

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  1. AS Dhoot et al., “Factors Affecting the Time to Publication in Ophthalmology Journals: A Comprehensive Bibliometric Analysis,” Ophthalmic Epidemiol, [Online ahead of print] (2021). PMID: 34027811.
  2. MR Mehra et al., “Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19,” N Engl J Med, [Retracted], 382, 2582 (2020). PMID: 32501665.
  3. MR Mehra et al., “Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis,” Lancet, S0140, 31180 (2020). PMID: 32450107.
  4. RJ Limaye et al., “Building trust while influencing online COVID-19 content in the social media world,” Lancet Digit Heal, 2, e277 (2020). PMID: 32322814.
  5. A Fridman et al., “COVID-19 and vaccine hesitancy: A longitudinal study,” PLoS One, 16, e0250123 (2021). PMID: 33861765.
About the Authors
Arjan Dhoot

Fourth-year medical student at the University of Toronto interested in pursuing a career in ophthalmology.


Marko Popovic

Resident physician in the Department of Ophthalmology and Vision Sciences at the University of Toronto. He is a Master of Public Health Candidate at Harvard University.


Jonathan Micieli

Comprehensive ophthalmologist and fellowship-trained neuro-ophthalmologist. He is an Assistant Professor in the Department of Ophthalmology and Vision Sciences at the University of Toronto.

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