The following disorders maybe a temporary or permanent bar to service as advised by the AFCO Medical Examiner: Eye Disorders Eye disease e.g. glaucoma, keratoconus, retinitis pigmentosa. Double vision. Visual field defects. Corneal grafts or recurrent comeal ulcers. Cataract or cataract surgery. Detached retina. Vision only in one eye. Squint surgery in the previous 6 months. Laser eye surgery in the previous 12 months. Current Visual Acuity Standards Standard I (VA1) Visual acuity to be achieved without correcting lenses Right 6/12N5, Left 6/12N5 Visual acuity to be achieved with correcting lenses Right 6/6N5, Left 6/6N5 Refraction limit: Total hypermetropia +3.00 sphere Astigmatism +1.25 cyl Myopia (in any meridian) -0.75 sphere or cyl +3.00 sphere Standard 2 (VA2) Visual acuity to be achieved without correcting lenses Right 6/60, Left 6/60 or worse. Visual acuity to be achieved with correcting lenses Right 6/6N5, Left 6/9N5 Refraction limit Spectacle correction (in any meridian) +/-6.00 sphere or cyl both. Standard 3 (VA3) Visual acuity to be achieved without correcting lenses Right 6/60, Left <6/60 Visual acuity to be achieved with correcting lenses EITHER Right 6/6N5, Left 6/24N10 OR Right 6/9N5, Left 6/18N10 OR Right 6/12N5, 6/12N10. Refraction limit Spectacle correction (in any meridian) +/- 6.00 sphere or cyl Below VA3, unacceptable for RM or RN service. VA3 is the minimum acceptable standard for entry as a RM Commando. Optician Report (CHG31 dated 04/01/2008) Following an in-Service issue where a person was unable to pass the Annual Personal Weapons Test (AWPT) due to the inability to close their left eye independently, all entrants to the Royal Navy and Royal Marines, including their Reserve counterparts, must now have this physical ability checked during the entrance medical. Annual Personal Weapon Test It is a mandate that all personnel deploying to an operational theatre must have passed the Annual Personal Weapon Test (APWT). To fire an SA80 rifle effectively the user must be able to independently close the LEFT eye. As part of the Entry Medical Examiners are to test for the ability to close the LEFT eye independently. Those unable to do so are unfit for entry. RM Other Ranks VA III, CP4 Except Aircrew VA I, CP1 Snipers VA I*, CP3 Landing Craft VA I*text deleted*, CP2 Swimmer Canoeists VA III*text deleted** CP3* (*Contact lenses not permitted) Colour Perception (CP) There are four standards of colour perception graded as follows: Standard Test Specification. CP4 is the minimum acceptable entry standard for RM Commandos and is the standard required because of the seagoing role. For most individuals, this will simply be undertaken using the Ishihara (coloured dots) test to grade you CP2 or CP4. Other services may well have lower acceptable colour perception standards worthy of further investigation. Certain specialisations need higher Colour Perception standards than the basic entry level, CP4. Standard Test Specification CP1 The correct recognition of coloured lights shown through the small paired apertures of the Holmes Wright lantern at LOW brightness at 6 metres distance in complete darkness. CP 2 The correct recognition of the first 17 plates of the ISHIHARA test (24 plate abridged Edition 1995 or later) shown at random sequence at a distance of 50 - 100 cm under standard fluorescent lighting supplied by an artificial daylight fluorescent lamp (British Standard 950:1967). CP3 The correct recognition of coloured lights shown through the paired apertures on the Holmes Wright lantern at HIGH brightness at 6 metres distance in complete darkness. CP4 The correct recognition of 13 out of the first 15 Ishihara plates or the correct recognition of colours used in relevant trade situations, and assessed by simple tests with coloured wires, resistors, stationery tabs etc. CP5 Unable to pass any of the above tests. Personnel who fail to reach the minimum standard of colour perception are to be graded CP5 - failed trade test and colour expanses. Methods of testing colour perception Ishihara test 1. Ishihara plates are used as a screening for all entries. 2. Candidates who pass the Ishihara test are graded CP2 and require no further testing (except for those whose critical visual task requires a categorisation of CP1). Those who score 13 out of 15 correct are graded CP4. 3.Candidates who fail the Ishihara test are further tested for CP3 or CP4 according to specific trade requirement. CP 5 Unable to pass any of the above tests. 1. Ishihara plates are to be used as screening for all entries. 2. Candidates who pass the Ishihara test are graded CP2 and require no further testing except for those whose critical visual task requires a categorisation of CP1. 3. Candidates who fail the Ishihara test are further tested for CP3 or CP4 according to requirement. 4. The Holmes Wright Lantern is to be used to discriminate CP1 and CP3. Appropriate trade testing (normally using a wire board and stationary tabs) will discriminate between CP4 and CP5. Ishihara Book Test 1. Examination Method: a. The test is conducted using only good diffused daylight directly onto the test plates or the alternative illuminant, all other light being excluded. b. The test plates are presented to the examinee at a distance of 50-100cm (20-40 inches) for not more than 5 seconds. The examinee may wear spectacles if appropriate. The winding line plates for illiterates normally need not be presented. c. Each number is read *text deleted**text deleted** by the examinee. They are not allowed to trace or handle the plates. d. The number of plates miscalled is recorded in the box on the examination form. 2. Assessment: If no error is made the examinee is graded CP2, but it should be noted that certain numbers might be miscalled by colour normals particularly when under stress. If not more than 3 plates are miscalled, the miscalled plates are shown again. If no errors are made on the second presentation, a grading of CP2 may be given. Those failing the test will require further assessment with lanterns or trade testing to determine if their colour vision is CP3, 4 or 5. Lantern Test 3. The Holmes-Wright Lantern Test is constructed to simulate in controlled conditions, the critical visual task of seamen. The test is usually performed by approved persons. The lantern is regarded as a form of trade test displaying pairs of vertically arranged lights in a combination of red, green and white. These are viewed at a distance of 6m (20 feet) either by direct vision or mirror reversal, in light surroundings or in total darkness as laid down in current instructions. LASER EYE SURGERY Anyone who is within the minimum required eyesight standards for entry is STRONGLY advised not to contemplate Laser Eye Surgery if under the age of 22 as they cannot be passed fit for entry, regardless of the fact 12 months have elapsed after surgery. Those undergoing Laser Surgery under the age of 22 can only be passed fit after 12 months have elapsed after surgery AND after reaching age 22. The reason for this is because your eyes are considered immature under age 22, so the long-term effects of the surgery cannot be considered stable until after this age. Below: Standard reply sent to all persons considering laser surgery, it's worth reading in depth: Thank you for your enquiry regarding eyesight corrective laser surgery (corneal refractive surgery) and the relevant Royal Navy Policy. The Naval Service does not endorse the use of laser surgery as a method to gain entry and there is no guarantee that such treatment will improve vision to an acceptable standard. The Naval Service requires individuals to serve anywhere in the world, in extremes of climate and operational situations, which are remote from primary and secondary care. Therefore, even minor conditions such as the use of correcting lenses can take on much greater significance when even basic support is limited. As a consequence, medical screening is stringent and to a higher standard than might be expected for normal civilian employment. In general, any defect or weakness of sight will be a bar to entry if these defects render an individual incapable of, or likely to be incapable of performing general duties in the Naval Service. The tri-Service standard for uncorrected visual acuity is right eye 6/60 and left eye> 6/60. With regard to surgical correction of myopia or hypermetropia, it is acknowledged that the following methods are now considered suitable for entry on an individual case by case basis for non-specialist employment groups and subject to single Service requirements: (a) Photorefractive Keratectomy (PRK) (b) Laser Epithelial Keratomileusis (LASEK) (c) Laser in-situ Keratomileusis (d) Intrastromal Corneal Rings (ICRs), otherwise known as Intrastromal Segments (ICS). Entry will not be considered for Radical Keratotomy (RK), or Astigmatic Keratotomy (AK), or any other form of incisional refractive surgery, other than those procedures listed above. All invasive intraocular surgical procedures will remain a bar to entry. In order to be considered a candidate must fulfil the following criteria and provide documentary evidence to support that: (a) The pre-operative refractive error was not more than +6.00 or 6.00diopter (spherical equivalent) in either eye and; (b) The best spectacle corrected visual acuity is 6/9 or better in each eye and; (c) At least 12 months have elapsed since the date of the last surgery or enhancement procedure and; (d) There has been no significant visual side effects secondary to the surgery affecting daily activities and; (e) Refraction is stable; as defined by two refractions performed on each eye at least 6 months apart, with no more than 0.50 diopter difference in the spherical equivalent in each eye. (f) Specialist visual function testing has been carried out with satisfactory results at least 12 months following surgery, including assessment of refraction, symmetry of visual acuity, high and low contrast sensitivity (with and without glare sources), astigmatism, glare, corneal clarity, masked mild hypermetropia and night vision. An applicant who has undergone eyesight corrective laser surgery must supply evidence of the above and may be subject to evaluation by a Service Ophthalmic Consultant. Each case is considered on an individual basis and if all the criteria are met it may be possible to consider an application to enter the Naval Service. Decisions regarding any kind of ophthalmic surgery should be discussed with an Ophthalmic Consultant. This letter should be taken to ophthalmic consultations where eyesight corrective laser surgery is to be discussed with a view to achieving the necessary eyesight standards for entry.