Cotton Wool Spots?



I was wondering if anyone has had cotton wool spots? I was diagnosed with LADA in April with an A1C of 11.3; in June, the optometrist told me that I had a cotton wool spot on my left retina but no evidence of any bleeding. Apparently it was visible on both the photos and the dilated eye exam.

Last week I had a follow up with my endo. A1C was down to 5.2. When I told him about the cotton wool spot, he seemed very surprised and said that you usually see evidence of bleeding long before cotton wool spots, and that the latter is usually a sign of more advanced retinopathy. He did an eye exam and saw nothing out of the ordinary.

At my follow up with the optometrist today, the spot had shrunk significantly but was still visible. Still no evidence of any bleeding.

Just curious if anyone has any experience with this phenomenon? Thanks.


Do yourself a big favor and go to an opthalmologist instead of an optometrist for a second opinion. An optometrist has no business doing medical examinations of eyes IMO.

I was told shortly after my diagnosis that I already had retinopathy by an optometrist. Both my endo and 2 seperate opthalmologists who subsequently examined me said that not only do I not have retinopathy, but that it was absurd for an optometrist to say that I did and that I should not ever see an optometrist again unless I just need glasses.


An opthalmologist is an MD. An optometrist is not. It’s up to each individual, but I know which one is going to be evaluating my eyes for medical purposes.


How does an endocrinologist even examine someone’s eyes for retinopathy? They don’t have medications/equipment needed to see into the back of the eye…?


They just look in there with their little flashlight that you peer through like any other regular doctor has in their pocket. What is it an otoscope? It’s a joke unless your entire eyeball was full of blood


Go to a retina ophthalmologist . I have 3 eye doctors, optometrist,Opthamologist and a retina opthamologist. I have a different type of retinopathy not related to diabetes. Nancy


I generally dislike agreeing with everyone let alone anyone too much. But the truth is you should find an Ophthalmologist; I saw an optometrist for years. The minute she said hey something might be going on, I made an appointment with an Opthamologist. As I recall I made it with the optometrist standing beside me, while i was shushing her.


Cotton wool spots can also occur for different reasons… I recently (back in April) had a BRVO (caused by what we believe to be a very tiny blood clot - my platelets at the time were CRAZY high as I was recovering from volume depletion prior to and following uterine surgery) and that caused several cotton wool spots which did eventually resolve. The cotton wool spots basically represent ischemia, which is just lack of blood flow - and there isn’t just one cause of those. Mine presented as a sudden loss in my visual field - it was very scary, and I saw my doctor immediately. My vision did “fully” return but there is still a slight distortion in that area which is likely permanent - but it’s not in the center of my vision and I can mostly ignore it.

I’ve had T1 for 16 years and while a few microaneurisms were seen in my other eye, and I was officially diagnosed with non-proliferative retinopathy as a result (though reassured by my doc that it isn’t something I really need to worry about at this stage - just keep doing what I am doing and I’ll be fine - but if we hadn’t done the fluorescein angiogram for the BRVO we never would have even caught it at this stage), the BRVO was completely unrelated to me having T1, and was really more of a freak thing that just happened.