The task
Assume that today's date is 22 October 2026. You examined Mr Suzuki this morning.
You are an optometrist in a community optometry practice. Using the information in the case notes, write a letter to Mr Suzuki's general practitioner, Dr Dmitri Wojcik, informing him of the diagnosis and the advice given, and requesting his support in helping Mr Suzuki stop smoking. Address the letter to Dr Dmitri Wojcik, General Practitioner, 112 Jacaranda Road. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Update letter.
Case notes
Patient details
- Name: Mr Farai Suzuki
- DOB: 14/03/1954 (72 yrs)
- Address: 27 Grevillea Avenue
- Seen 22/10/26 for routine eye exam; last eye exam 2023
Social background
- Retired electrician; lives with wife
- Enjoys woodwork and cryptic crosswords
- Drives locally, mostly in daytime
- Smoker: approx. 20 cigs/day since age 16
- Previous quit attempt 2019 with nicotine patches; relapsed after 3/12
- Daughter told receptionist she is 'fed up' with him smoking in the car with the grandchildren
- Pt complained about 40-min wait in reception
Medical history
- Hypertension: amlodipine (managed by GP)
- Hypercholesterolaemia: atorvastatin
- Appendicectomy 1975
- Allergies: nil known
- FHx: older brother had macular degeneration, legally blind in his 80s
Presenting complaint
- Gradual ↑ difficulty reading small print and seeing in dim light over 6/12
- No distortion; no sudden ↓ vision
Assessment
- VA (with glasses): R 6/7.5, L 6/9; near N6 both eyes with reading add
- Dilated fundus exam: multiple medium-sized drusen both maculae; no haemorrhage or exudate
- OCT: drusen R and L; no subretinal or intraretinal fluid
- Amsler grid: no distortion either eye
- IOP normal both eyes; mild nuclear cataract both eyes, not visually significant
- Dx: early dry (non-neovascular) AMD both eyes
Management
- Dx explained; pt shocked, worried about losing sight like brother
- Smoking explained as major modifiable risk factor for AMD progression → pt keen to quit now
- Amsler grid given: check each eye separately daily, wearing reading glasses
- Advised: sudden distortion, new blur or dark patch → contact practice same day or attend emergency eye dept (possible wet AMD, needs urgent treatment)
- Advised healthy diet (leafy green vegetables, fish) and UV protection outdoors
- Asked about eye vitamin supplements: not indicated at this early stage; reconsider if AMD progresses
- Quitline information given; pt consented to letter to GP
- New reading spectacles prescribed; advised brighter task lighting
Plan
- Letter to GP: inform of Dx; request smoking cessation support, incl. discussion of pharmacotherapy options
- Review 12/12 with OCT, sooner if symptoms change
- Low-vision services not required at present
Who is reading, and what do they need?
Dr Wojcik is the GP who manages Mr Suzuki's hypertension and is not an eye specialist. He needs the diagnosis in clear terms, what the patient has been told and given, and the specific request for cessation support including pharmacotherapy options. Technical retinal detail should be brief.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Dx: early dry (non-neovascular) AMD both eyes | This is the diagnosis the letter must report and the basis for the request. |
| Multiple medium drusen both maculae; no haemorrhage, exudate or fluid on OCT | Brief supporting findings show the disease is early and without signs of wet disease. Keep to one line. |
| Difficulty reading small print and in dim light over 6/12; no distortion | The presenting symptoms explain how the diagnosis arose, and the absence of distortion is a useful negative. |
| Older brother had macular degeneration, legally blind in his 80s | Family history is a relevant risk factor and explains the patient's worry, which affects counselling. |
| Smokes approx. 20/day since age 16; smoking explained as major modifiable risk factor for progression | This is the core of the cessation request and uses the card's wording on risk, not a claim of cause. |
| Quit attempt 2019 with patches, relapsed after 3/12; now keen to quit | Past attempt and current motivation help the GP plan support, and they lead into the request to discuss pharmacotherapy options. |
| Amsler grid daily; sudden distortion, new blur or dark patch means same-day contact or emergency eye department | The GP should know the safety advice. If included, give all three symptoms and both actions, as one complete set. |
| Review 12/12 with OCT; Quitline info given; patient consented to letter | This shows follow-up, what support is already provided, and that sharing information is agreed. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Daughter told receptionist she is 'fed up' with him smoking in the car with the grandchildren | Trap: it relates to smoking but is a third party's secondhand remark, not the patient's information, and could damage trust. |
| Pt complained about 40-min wait in reception | A complaint about the practice has no bearing on the diagnosis or the request to the GP. |
| Retired electrician; woodwork; cryptic crosswords; drives locally in daytime | Social colour that does not support the diagnosis, advice or request. |
| Supplements not indicated at this stage; low-vision services not required | Negative decisions that do not require GP action; mention only if words allow, and not at the expense of required content. |
| Mild nuclear cataract not visually significant; IOP normal; amlodipine, atorvastatin, appendicectomy | Compress or omit. Incidental normal or non-significant findings and the GP's own medicines do not change the request. |
A paragraph plan for this case
State the purpose and the diagnosis first with the supporting findings and symptoms. Then cover risk factors, with smoking history, past quit attempt and current motivation, followed by advice given and follow-up, ending with the clear request for cessation support including pharmacotherapy discussion.
Where candidates slip on this task
- Frame the request exactly as the plan does: support to stop smoking, including discussion of pharmacotherapy options. Do not name particular drugs or doses, since none appear in the notes.
- Describe smoking as a major modifiable risk factor for progression, as the notes say. Do not say it caused the condition, and do not predict that he will lose sight.
- If you mention the warning symptoms, give the whole advice: sudden distortion, new blur or dark patch, with same-day contact or emergency eye department. Do not shorten it, and do not invent post-dilation advice.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Optometry letter tasks
- Diabetic eye check: early retinopathy found update letter
- Routine referral for cataract assessment referral letter
- Bilateral optic disc swelling: urgent referral referral letter
Your profession's guide: OET Optometry. Layout and structure: OET letter format.
Questions about this task
Can I mention the daughter's comment about smoking in the car?
No. It was told secondhand to a receptionist and is not part of the patient's own history. The request can rest on his smoking history, the risk to his eyes and his readiness to quit.
Should the eye vitamin discussion be included?
It is optional and low priority. The notes say supplements are not indicated at this early stage. If space is short, leave it out and prioritise the diagnosis, advice and the smoking request.
Sources
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