Certified Paraoptometric (CPO) Practice Exam 2025

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What characteristic do cotton wool spots exhibit in retinal examination?

Small dark spots representing hemorrhage
White fluffy deposits indicating retinal ischemia
Areas of increased pigmentation in the retina
Cysts filled with fluid in the retinal layer

The correct answer is: White fluffy deposits indicating retinal ischemia

Cotton wool spots are indeed characterized as white fluffy deposits observed during a retinal examination. These spots are indicative of retinal ischemia, which occurs when there is reduced blood flow to the retina. They represent localized areas of axoplasmic material that accumulate due to the obstruction of axoplasmic flow in the nerve fiber layer of the retina, often due to occlusion of pre-capillary arterioles. This phenomenon is significant because it points to underlying vascular conditions and can be associated with various systemic diseases like diabetes and hypertension. Recognizing cotton wool spots is essential for clinicians, as their presence can help signal more serious underlying health issues requiring further investigation.