Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What are cotton wool spots associated with in the context of retinal examination?

1. Cataracts

2. Papilledema

3. Soft exudates

4. Retinal tears

The correct answer is: Soft exudates

Cotton wool spots, observed during a retinal examination, are indicative of localized retinal ischemia, which occurs when there is an accumulation of axoplasmic material due to blockage of the pre-capillary arterioles. These spots appear as fluffy white patches on the retina and are a type of soft exudate. Their presence is typically associated with various retinal conditions, including diabetic retinopathy and hypertension. The associated pathology involves damage to the nerve fiber layer resulting in the characteristic appearance of these spots. They do not imply cataracts or retinal tears directly, nor are they specifically linked to papilledema, which typically presents with swelling of the optic disc rather than cotton wool spots. Understanding the appearance and implications of cotton wool spots is crucial for assessing the underlying health conditions affecting the retina and the overall vascular health of the individual.