Australian Government - Australian Maritime Safety Authority
NEAR COASTAL EYESIGHT TEST CERTIFICATE – AMSA 542
Marine Safety (Domestic Commercial Vessel) National Law Act 2012
Marine Order 505 (Certificates of competency – national law) 2013
 

Guidance on when to use this form
This form is to be completed by a qualified Medical Practitioner/Optometrist, who should read the the document Guidelines for the medical assessment of near coastal seafarers which can be found at Guidelines for medical assessment near coastal
A. Applicant details
Title (Mr, Mrs, Dr, etc)
Surname
Given names
Street name and number
Town/suburb
State
Postcode
Date of birth
Certificate of competency type / Exemption 38
B. Proof of identity
Passport Drivers licence Other (specify)
Number
C. Results of examination
  1. Letter test (Snellen Principle) with or without aids to vision
    Left Right
    1. Does the applicant meet the master / mate / coxswain / GPH / Exemption 38 certificate requirements?
      • Minimum acceptable is 6/6 in the better eye and 6/9 in the other eye with or without aids to vision.
    2. Does the applicant meet the engineering certificate requirements?
      • Minimum acceptable is 6/12 in both eyes with or without aids to vision.
  2. Does the applicant meet the near vision requirements?
    • Read N8 chart at 300mm – 500mm with or without aids to vision.
  3. Were aids to vision used to achieve minimum and near vision requirements?
  4. Does the applicant meet the colour vision requirements for master / mate / coxswain / GPH?
    • The ISHIHARA Test with or without aids to vision; or
    • The Holmes-Wright Lantern Test Type B with or without aids to vision.
  5. Does the applicant meet the colour vision requirements for Marine Engine Driver Class 1 / Engineer Class 3?
    • The ISHIHARA Test with or without aids to vision; or
    • The Holmes-Wright Lantern Test Type B with or without aids to vision; or.
    • A colour-matching test in accordance with Marine Order 76 (Health - medical fitness) 2017 Farnsworth D15 recommended).
 
D. Medical Practitioner / Optometrist / Ophthalmologist declaration.
    I have evaluated the above named applicant and, on the basis of their personal declaration and my clinical examination,I declare the applicant meets the vision requirements for the certificate type noted on this certificate.
    I have evaluated the above named applicant and, on the basis of their personal declaration and my clinical examination, I declare the applicant meets the colour - vision requirements for the certificate type noted on this certificate?


Medical Practitioner signature
Medical Practitioner name
Date of examination (valid for 2 years)
Medical Practitioner address
Medical Practitioner phone number
Privacy Statement
The collection of information requested in this form is required or authorised by Schedule 1 of the Marine Safety (Domestic Commercial Vessel) National Law Act 2012 (the Act). It will be used for purposes related to the Act and may be provided to Commonwealth or State/Territory government agencies for the purposes of marine safety. Failure to provide the information may result in the transaction not being processed. To contact us, or for more information on how to access or correct your personal information, how to make a privacy complaint, or how your information may be used or disclosed for purposes beyond those described in this statement, visit www.amsa.gov.au/privacy.


Guidance notes

General considerations
Refer to the Guidlines for the medical assessment of near coastal seafarers.

Certificate of competency types
Certificate
Marine Engine Driver Grade 3 NC
Marine Engine Driver Grade 2 NC
Marine Engine Driver Grade 1 NC
Engineer Class 3
General Purpose Hand (GPH)
Coxswain Grade 2 NC
Coxswain Grade 1 NC
Master < 24 m NC
Master (Inland waters)
Master < 35 m NC
Mate < 80 m NC
Master < 80 m NC

Vision
  • The term “aids to vision” means glasses or contact lenses which have been prescribed by a qualified optometrist or eye specialist to correct a person’s eyesight.
  • Monocular Vision (Deck and Engine crew) - for an applicant who has vision in only 1 eye, the applicant does not have to meet the standard that applies to the other eye; and the certificate must include a statement that the applicant meets the standard with monocular vision only.
 

Colour Vision
  • Applicants for the certificates listed in the table below do not need to meet the colour vision testing requirements.
    Certificate
    Marine Engine Driver Grade 3 NC
    Marine Engine Driver Grade 2 NC
  • The only optical aids permitted to be used for colour vision testing are prescribed lenses worn by an applicant for the acuity test. An applicant may not use tinted glasses or tinted contact lenses.
  • The primary screen for colour vision is the Ishihara test. If this is passed the standards are met and a seafarer is considered colour vision safe for lookout and engine room duties.
  • If a seafarer (master, mate or coxswain, GPH or holder of Exemption 38) passes either an Ishihara test or a Holmes Wright Lantern Type B (HWB) test they are considered red-green colour safe for watchkeeping and lookout duties at night.
  • If a seafarer passes either an Ishihara test, HWB test or a Farnsworth D15 colour vision matching test he or she is considered red-green colour safe for all engineering tasks.
  • The Ishihara test shall be conducted using all 24 plates. In order to pass, a candidate must correctly identify at least 13 of the first 15 plates in the 24-plate version.
  • The National Regulator may, in lieu of the above requirements, accept a statement from a suitably qualified optometrist, eye specialist or medical practitioner, that; after having examined the applicant, the applicant suffers no greater abnormality in colour-vision than could be tested by the Ishihara Test.
How to lodge

For all CoC applications lodge with AMSA 426 form.

For all other applications/purposes please email to AMSAConnect@amsa.gov.au

For Exemption 38 you do not need to submit this form but you must carry the form with you at all times when operating under the exemption.

AMSA form: 542
Version: 1 7/18