The task
Assume that today's date is 22 October 2026. Bruno has just been re-examined at your practice this morning.
You are the veterinarian at a general veterinary practice who has been treating Bruno. Using the information in the case notes, write a letter of referral to Dr Ramesh Talukder, a veterinary ophthalmologist, requesting urgent assessment and possible surgical management of Bruno's right eye. Address the letter to Dr Ramesh Talukder, Veterinary Ophthalmologist, Veterinary Eye Referral Service, 48 Bridge Street. 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: Referral letter.
Case notes
Patient details
- Patient: Bruno, Pug, male neutered, 4 yrs
- Weight: 8.6 kg
- Owner: Ms Achieng Sokolova; works from home, able to transport Bruno today
- Pet insurance; owner agrees to referral and surgical costs
Social background
- Lives indoors with owner + 1 adult cat; owner saw cat swipe at Bruno's face 11/10 → suspected cause of ulcer
- Enjoys daily walks to local dog park; plays with neighbour's dog
- Owner complained at reception that vet nurse was 'rude and rushed' at last visit
- Owner reports neighbour said Pugs 'should be banned from breeding'
Medical history
- Brachycephalic obstructive airway syndrome: stertor, snores, exercise intolerance in hot weather; no airway surgery to date
- Prominent globes, incomplete blink (lagophthalmos) OU; nasal fold close to R cornea
- Vaccinations up to date; parasite control current
- Skin fold dermatitis 2024 — resolved with topical tx
- Allergies: nil known
Presentation 12/10/26
- Blepharospasm + epiphora R eye (OD) × 1 day
- Fluorescein +ve: superficial central ulcer OD approx. 3 mm; no stromal loss; no foreign body; lashes normal
- Schirmer tear test OU: within normal limits
- Rx: chloramphenicol eye drops OD QID; meloxicam PO SID; Elizabethan collar
Progress
- 15/10: ulcer size unchanged; comfortable; same tx continued
- Owner admits collar removed at night 'so he can sleep' — seen rubbing eye on carpet
- 20/10: ulcer ↑ approx. 5 mm; stromal loss approx. 1/3 depth; cytology: rod-shaped bacteria + neutrophils; culture & sensitivity sent; changed to ofloxacin eye drops q2h around the clock (day and night) + atropine eye drops SID; collar 24 hrs/day
- 22/10 (today): soft, grey, gelatinous ('melting') stroma, approx. 6 mm, approx. 1/2 stromal depth; marked corneal oedema; miosis; ↑ pain; Seidel test -ve; no descemetocele seen
- Culture result (rec'd 22/10): Pseudomonas aeruginosa, sensitive to ofloxacin
- Left eye (OS): normal on examination
- Eating normally; bright; temp normal
- Owner asked if Bruno can still attend groomer's appointment next week
Current treatment
- Autologous serum eye drops OD q2h started 22/10; ofloxacin q2h day and night (intensive regimen agreed with Dr Talukder by phone) to continue until handover - owner giving; practice to administer in hospital if owner unable; atropine SID, meloxicam SID, collar 24 hrs/day
- Last meloxicam 08:00 today; no food since last night (fasted for possible GA)
Plan
- Urgent referral to veterinary ophthalmologist: assessment ± surgery (e.g. conjunctival graft)
- Phoned Dr Talukder's clinic 22/10: appt today 15:00; owner to bring Bruno + all eye meds
- Cytology + culture reports enclosed
- Owner advised: keep collar on at all times; keep cat separated
- Owner understands eye may need surgery; keen to save eye
Who is reading, and what do they need?
Dr Talukder is a veterinary ophthalmologist who already knows about the case from today's phone call, including the agreed intensive ofloxacin regimen and the 15:00 appointment. The reader needs a concise clinical picture, the culture result, current treatment and anaesthetic readiness. Basic ophthalmic terms need no explanation, and routine or social detail is not needed.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Owner saw cat swipe at face 11/10; ulcer 3 mm, superficial, 12/10 | Gives the suspected cause and the baseline for judging progression. The cause is suspected only, so the letter should not state it as established. |
| Ulcer 5 mm with 1/3 stromal loss on 20/10; 6 mm, 1/2 depth today | The size and depth change across the dates is the justification for urgency, and the specialist needs the sequence. |
| Melting stroma, marked oedema, miosis, ↑ pain, Seidel -ve, no descemetocele seen | Today's findings determine surgical urgency. The negative Seidel test and absent descemetocele should be reported as observed, not as proof of integrity. |
| Pseudomonas aeruginosa, sensitive to ofloxacin; cytology rods + neutrophils | The organism and sensitivity guide ongoing therapy. The reports are enclosed, so the letter only needs to summarise them. |
| Serum drops started today; ofloxacin q2h, atropine, meloxicam, collar; fasted, last meloxicam 08:00 | The specialist must continue therapy without gaps and plan possible anaesthesia, so timings, fasting and the treatments in place all matter. |
| Collar removed at night, seen rubbing eye on carpet | Self-trauma and incomplete collar use are relevant to the course. Report them factually without assigning blame or a cause. |
| Prominent globes, lagophthalmos OU, nasal fold near R cornea, BOAS | These anatomical and airway factors bear on the eye's course and on anaesthetic planning, and no airway surgery has been done. |
| Owner keen to save eye; understands surgery; agrees to referral and surgical costs | Confirms informed consent to proceed. State only the owner's agreement, not what the insurer will cover. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Owner complained vet nurse was 'rude and rushed' | A practice complaint with no bearing on the eye or the specialist's decisions. It should be handled separately. |
| Neighbour said Pugs 'should be banned from breeding' | Hearsay opinion with no clinical relevance. |
| Owner asked about groomer's appointment next week | Looks like an aftercare issue but is a question for the practice and owner to deal with. The specialist will decide on care after assessment. |
| Daily dog park walks; plays with neighbour's dog | The notes link no lifestyle factor to the ulcer other than the cat. This is routine social detail. |
| Skin fold dermatitis 2024, resolved; vaccinations and parasite control current | A resolved, unrelated problem and routine preventive care add nothing to the eye decision. |
| Schirmer test normal OU; left eye normal | Only a brief mention at most. It is not the focus of an urgent right-eye referral. |
A paragraph plan for this case
Open with the purpose, the urgency and the appointment already arranged. Then give the ulcer's course from 12/10 to today, with findings, culture result and the treatment given. Close with relevant anatomy and airway history, fasting status, owner's wishes and enclosures.
Where candidates slip on this task
- Dates and measurements must be exact: 3 mm on 12/10, 5 mm and about 1/3 depth on 20/10, 6 mm and about 1/2 depth today. Do not add trends or causes the notes do not state.
- Report the intensive ofloxacin regimen as agreed with Dr Talukder by phone and continuing until handover. Do not write that the regimen began today, since serum drops are the treatment started today.
- Word the Seidel result and absent descemetocele as observations. Do not imply the cornea is safe, and do not say the cat caused the ulcer as a fact.
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 Veterinary Science letter tasks
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- Grape ingestion treated at an out-of-hours emergency clinic update letter
- Discharge after colic surgery in a horse update letter
Your profession's guide: OET Veterinary Science. Layout and structure: OET letter format.
Questions about this task
Should the letter mention that the owner removed the collar at night?
Yes, briefly and factually, because self-trauma and the rubbing on carpet are part of the clinical course. Present it as what the owner reported and what was seen, without blame or a conclusion that it caused the deterioration.
How should the insurance and cost information be handled?
Only the owner's agreement to referral and surgical costs is stated in the notes, so report that. Do not claim the insurer covers surgery, because the notes only say the owner has pet insurance.
Sources
Last checked 22 Oct 2026. Rules and prices change: confirm on the official page before you book or apply.
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