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Optometry

Read the following information.

Free OET Writing Sample Test with Answer Subtest Optometry #11

Using the information given in the case notes, write a referral letter to an ophthalmologist.

Case Notes

  • Patient: Mr. John Matthews, 62 yrs

  • Medical history: Type 2 Diabetes (10 years), Hypertension (controlled)

  • Family history: Father blind due to glaucoma

  • Presenting complaint: Blurred vision in both eyes (onset: 3 months, gradual)

  • Symptoms: Trouble reading small print, difficulty driving at night, occasional eye pain, increased glare sensitivity

  • Examination findings:

    • Visual acuity: RE 6/18, LE 6/24

    • Fundoscopy: Early diabetic retinopathy changes (microaneurysms, cotton wool spots)

    • IOP: RE 24 mmHg, LE 23 mmHg (elevated)

    • Visual fields: Peripheral constriction, more marked in left eye

  • Current correction: Wears glasses, but still reporting blurred vision

  • Management so far: Refractive correction tried – minimal improvement

  • Concerns: Possible glaucoma + diabetic eye disease

  • Request: Ophthalmology review, further diagnostic imaging (OCT, visual field testing), treatment options

Ophthalmology Department
City General Hospital

Dear Doctor,

I am referring Mr. John Matthews, a 62-year-old gentleman with diabetes and hypertension, who presents with progressive visual impairment suggestive of glaucoma and diabetic eye disease.

Mr. Matthews has been experiencing blurred vision in both eyes for the past three months, which is gradually worsening. He struggles to read small print, reports glare sensitivity, and has difficulty driving at night. He also complains of intermittent eye discomfort.

Examination revealed reduced acuity (RE 6/18, LE 6/24) despite optimal refractive correction. Fundoscopy showed early diabetic retinopathy with microaneurysms and cotton wool spots. Intraocular pressures were elevated bilaterally (RE 24 mmHg, LE 23 mmHg). Visual field testing demonstrated peripheral constriction, more significant in the left eye.

Given his family history of glaucoma and the combination of findings, I am concerned about a dual diagnosis of diabetic retinopathy and open-angle glaucoma. He will clearly benefit from an urgent ophthalmology assessment. I would appreciate your further investigations, including OCT and formal perimetry, and consideration for medical or surgical intervention as appropriate.

Thank you for your attention to this case.

Yours sincerely,
Optometrist

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