What does cotton wool patches indicate in a patient?

Cotton wool patches are small, fluffy white patches on the retina that are caused by localized retinal ischemia, which can occur due to various underlying conditions. They represent areas where there is a blockage of axoplasmic flow along the retinal nerve fiber layer. This blockage is associated with a disruption of the normal functioning of retinal ganglion cells, which leads to the accumulation of axoplasmic material.

These patches often indicate underlying health issues, such as hypertension, diabetes, or other conditions that can affect vascular health. Their presence serves as a clinical marker for potential systemic diseases, particularly in relation to the health of the microvasculature in the retina.

In contrast, increased intraocular pressure is more commonly associated with glaucoma and the resulting damage to the optic nerve, not specifically with cotton wool patches. Assessing vision typically involves other evaluations but does not directly relate to the findings of cotton wool spots. Normal retinal findings would not include cotton wool patches, as their presence signifies some level of pathological process occurring in the retina.