What does the term 'cotton wool spots' refer to during an eye examination?

The term 'cotton wool spots' refers specifically to retinal damage observed during an eye examination. These spots are small, fluffy white patches on the retina, which represent localized accumulations of axoplasmic material that occur when the nerve fiber layer of the retina is damaged. They are often indicative of underlying retinal ischemia or dysfunction, which can be associated with various conditions such as hypertension, diabetes, and other vascular disorders affecting the eye.

Cotton wool spots are of clinical significance because their presence can signal the need for further investigation into the patient's systemic health, particularly their vascular status. The identification of these spots can lead to early detection and management of diseases that, if left unchecked, could result in more significant retinal complications, including vision loss.