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Optometry

Read the following information.

Free OET Writing Sample Test with Answer Subtest Optometry #14

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

Case Notes

  • Patient: Mr. Rajesh Kumar, 58 yrs

  • Medical history: Type 2 diabetes (12 yrs, poorly controlled), smoker, high cholesterol

  • Family history: No known eye disease

  • Presenting complaint: Gradual loss of central vision (both eyes) for 8 months

  • Symptoms: Difficulty reading fine print, distorted vision (straight lines appear wavy), colors appear faded

  • Examination findings:

    • VA: RE 6/36, LE 6/24

    • Amsler grid: Metamorphopsia both eyes

    • Fundus: Macular edema, hard exudates, microaneurysms

    • IOP: Normal

  • Management so far: Glasses provided – minimal improvement

  • Request: Ophthalmology assessment for diabetic macular edema, possible laser or anti-VEGF therapy

Ophthalmology Department
City Hospital

Dear Doctor,

I am referring Mr. Rajesh Kumar, a 58-year-old diabetic patient, for urgent ophthalmology review due to progressive central vision loss suggestive of diabetic macular edema.

Mr. Kumar has noticed a gradual blurring of central vision for eight months. He reports distortion of straight lines and difficulty distinguishing colours, which is affecting his daily activities such as reading and driving.

On examination, his visual acuity was reduced to 6/36 in the right eye and 6/24 in the left. The Amsler grid confirmed metamorphopsia bilaterally. Fundoscopy revealed macular edema with hard exudates and multiple microaneurysms consistent with diabetic maculopathy. Intraocular pressures were within normal limits. His refractive correction has not improved visual clarity.

Given his long-standing diabetes, poor metabolic control, and progressive symptoms, I suspect sight-threatening diabetic macular edema. I would appreciate your further assessment with OCT imaging and consideration of laser photocoagulation or intravitreal anti-VEGF therapy.

Thank you for your urgent attention.

Yours sincerely,
Optometrist

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