Cotton Wool Spots

  • White spots on retinal surface caused by microinfarction
  • Usually do not produce vision loss unless large or near fovea
  • Causes are hypertension, diabetes, HIV, lupus, severe anemia or thrombocytopenia, hypercoagulable states, connective tissue disorders, viruses, lues, Behçet, Purtscher, and many others
  • Like dabs of white paint within 5 optic disc diameters of optic disc
  • Retinal drusen, chorioretinal atrophy, inflammatory retinal infiltrate, myelinated nerve fibers
  • These yellow-white things in retina are difficult to distinguish from each other
  • Refer to ophthalmologist non-urgently if incidental finding, urgently if associated with active illness or new vision loss
  • Depends on underlying cause