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Q. There is a hemorrhage in the eye and a cotton wool spot. Is this serious?

Answered by
Dr. Rahul Vaswani
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 23, 2018

Hello doctor,

I have recently had an eye test done and it revealed that I have astigmatism, also there is a hemorrhage 2 DD superior to macula 2 DD in the left eye and a cotton wool spot 2.5 DD supero-temporal to the optician's disc in the right eye. I am hypertensive but my BP is under control with medication.My question is could this be related to my BP and what degree of urgency would this be? I have been referred to an eye hospital.

Dr. Rahul Vaswani

Ophthalmology (Eye Care)


Welcome to

Yes, this probably is related to hypertension. You are currently suffering from hypertensive retinopathy.

Now your BP is under control but previous longterm episodes of uncontrolled BP has led to the narrowing of blood vessels in your retina and this has led to a response from your retina which led to the formation of new and leaky blood vessels. These vessels leak blood.

Also, cotton wool spots indicate that it is hypertensive retinopathy.

Now, coming to the treatment part:

  • You have to visit a vitreoretinal expert who will perform following tests
  1. OCT (optical coherence tomography).
  2. FFA (fundus fluorescein angiography).

Both these tests will confirm if there is fluid accumulation inside the retina and also areas with these new vessels. In this treatment, you have to get pan-retinal photocoagulation plus I suggest you get injection antiVEGF substance.

Along with that kindly see your specialist doctor to revise your antihypertensive treatment.

For further queries consult an eye care ophthalmologist online -->

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Thank you doctor,

Is the injection something that I will need regularly?

Dr. Rahul Vaswani

Ophthalmology (Eye Care)


Welcome back to

The protocol is to treat and observe. If there is retinal edema which in my practice is always there, first they will inject you with a dose of antiVEGF and at the first follow up, you will be needing a pan-retinal photocoagulation to laser off the new vessel areas with known neovascularization.

Then, if the edema persists you will be needing further injections. Injections carry quite a cost in your country. So, I suggest you make sure you have insurance.

For more information consult an eye care ophthalmologist online -->

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