Cotton-wool and causes

My eye doctor found a cotton-wool spot in one of my eyes, and has sent me to get an HIV test. I am not in a high-risk catagory, but I am given to understand that there are 3 diseases that can cause cotton-wool, and it is clear that I do not have the first two. My question is two-fold: first, are there other factors that can cause c.w., or is it typically symptomatic of one of the above diseases, and 2) what are the chances that an eye infection I had as a teenager could have caused the spot? I should mention that my opthamologist did not find generalized c.w. spots, i.e. several small ones over both eyes, but rather one large on in one eye, and he sent me to research the conditions at the time. This, sadly, has been fruitless, as my mother does not remember the infection, so I am left with only vague recollections. At the time of my infection, I recall my doctor telling me that part of my retina(I believe-I was pretty young) had been 'eaten away' and that I would have, techinically, a permanent blind spot, although I would never actually notice it. I do believe that it was at the back of my eye. Could this be the cause of this cotton-wool spot? Should I be freaking out?

[Kevin Pho, MD]

Cotton wool spots occur because of swelling in the surface layer of the retina.  Restricted blood flow to the area almost always leads to the swelling.  Eventually the nerve fibers are damaged, leading to the cotton weool spots.  Diabetes and hypertension are the two most common diseases that cause these spots, and the best treatment would be to treat the underlying disease.

Any insult to the blood supple to the retina can cause a spot, and it may be possible that the infection you previously had may contribute to this.  

It should be noted that cotton wool spots often goes away on their own.  If you haven't been screened for diabetes and hypertension, this should be considered.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[shumitd]

To the MD: Was this reply written late at night, without much thought? It was incomplete, grammar was awful, and you didn't really answer my question. I don't think you should offer a forum like this if you aren't prepared to do a thoruogh job, and I'm not sure who i donated 15 dollars to, but considering, I hope you feel at least a little guilty for making money off worried people without offering or giving full attention.

[lmroswell]

What exactly does a cotton wool spot look like?  Do you see it in your vision?

[TJV]

   Hi  Cotton wool spots are not caused by just 3 diseases, there are numerous causes, and in some people---- no cause can ever be found.   They are not harmful in themselves , and as the doctor says, in many cases they go away on their own.  I wouldn't worry too much about it, i would worry more however if more spots develop.

  Causes besides diabetes and hypertension can be infections, a viral infection even , trauma  to the head, eye or chest, , anemia is a common cause , arthritis, lupus,  and other systemic autoimmune disorders, pancreatitis, hmmmm - inflammatory conditions of the blood vessels etc.  Even if you knew the infection you had as a child , it would be impossible to say this was the cause for sure.

  As the doctor said ---- if you haven't already,  you should  get screened for diabetes and hypertension. You should also have a CBC ( complete blood count) ANA , etc. You can discuss the tests needed with your doctor if you'd like to explore possible causes.

   Have you had any tests to look at the blood flow through your retinal vessels. ?  

[silver2]

My eye exam today revealed coton wool spots in both eyes that are "raised" in appearance. The doctor indicated that he didn't understand the "raised" areas and would need to do research and call me tomorrow. I do have chronic hypertension, but worry if the strange "raised' areas could be a serious condition I don't know about. Could the "raised" areas be signs of a serious condition I don't know about? Are raised cotton wool spots unusual? Help!