The candidate card
Setting
Optometry practice
Candidate
You are an optometrist. Mr Bongani Kimura, aged 67, has come in for new reading glasses and has no eye complaints. Today's examination shows confirmed eye pressures of 25 mmHg in the right eye and 26 mmHg in the left, open drainage angles, mild glaucomatous cupping of both optic discs and an early visual field defect in his right eye, with no features of an eye emergency. These findings suggest early open-angle glaucoma, and you plan to refer him to an ophthalmologist on a non-urgent basis.
Task (interlocutor: patient)
- Explain today's findings in simple terms (eye pressure, optic nerve, side vision)
- Explain why early glaucoma usually causes no symptoms and why it needs to be confirmed and treated
- Find out about his reluctance to see a specialist and his concerns
- Persuade him of the importance of the referral, addressing his worries about cost
- Agree a plan for the referral and his reading glasses
In the test you get 3 minutes to read the card and plan, then about 5 minutes to talk. This card is original, written for this site; the interlocutor's card is not shown.
How to approach this card
- Because he came for reading glasses with no complaints, the news will surprise him. Start by signalling you found something he should know, then explain pressure, nerve and side vision in a few plain sentences.
- Say the findings suggest early glaucoma, which a specialist needs to confirm. Do not tell him definitively that he has it, and do not downplay it. Mention the early side-vision change in his right eye.
- Explain why no symptoms does not mean no problem: early glaucoma usually causes none, which is why confirming and treating it matters. Then ask what makes him reluctant to see a specialist, and listen to the answer.
- His worries about cost are the stated barrier, but explore other fears too. Be honest about what you know and avoid inventing figures. Offer to help him find out the costs, and stress the referral is not an emergency.
- Close with the referral steps and what happens to his reading glasses, so his original reason for coming is dealt with. Ask him what he will do next and confirm he knows who to contact.
Phrases to adapt
Use your own words; these show the register, not lines to memorise.
- I've found something that doesn't hurt, but it's worth taking seriously.
- What is it about seeing a specialist that you're unsure of?
- Cost is a fair worry. Let's look at what we can find out together.
- We'll sort your reading glasses today as well, so you leave with that done.
Medical words in plain English
| Term | How you might say it to the patient |
|---|---|
| intraocular pressure | The fluid pressure inside your eye, which is higher than we like to see. |
| optic disc cupping | A change in the head of the eye's nerve, which can be a sign of glaucoma. |
| visual field defect | A patch of your side vision that isn't working as well as it should. |
How this card is marked
Two assessors mark the recording on nine criteria: intelligibility, fluency, appropriateness of language and resources of grammar and expression (each 0–6), then relationship building, understanding and incorporating the patient's perspective, providing structure, information gathering and information giving (each 0–3). Grade B usually means 5 on each language criterion and 2 on each clinical one. See the AI Speaking practice guide for what each criterion looks for.
More Optometry role-play cards
- Retinal tear: same-day referral before a flight Optometry practice
- Cataract: vision below the driving standard Optometry practice
- Child's progressing myopia: glasses and myopia control Optometry practice
All sets: nurses, doctors, other professions. Your profession's guide: OET Optometry.
Questions about this role-play
What if he says he sees fine and doesn't need a specialist?
Agree that he sees well day to day, then explain that early glaucoma often causes no symptoms and the side-vision change is picked up by testing. Say the specialist will confirm the diagnosis and discuss treatment if needed.
How should I answer questions about cost?
Do not guess at figures or what he will pay. Acknowledge the concern, say you will help him find out costs and options through the practice or referral, and explain that the visit is to confirm the findings and decide on treatment.
Should I say he will lose his sight?
No. Avoid frightening predictions that go beyond the card. Say early glaucoma needs confirming and treating, that the early side-vision change is why follow-up matters, and that he is not facing an emergency today.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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