Dots & Spots in Ophthalmology

• Leopard spots: in FFA, resulting from patchy subretinal infiltrates in a patient with reticulum cell sarcoma.
• Histo spot: Punched-out chorioretinal scars in Presumed ocular histoplasmosis syndrome (POHS)
• Cotton-Wool Spots: Diabetic retinopathy is the most common cause of cotton-wool spots. Cotton-wool spots have been associated with numerous other abnormalities, such as systemic arterial hypertension, collagen vascular diseases, cardiac valvular disease, carotid artery obstructive disease, coagulopathies, metastatic carcinoma, trauma, and human immunodeficiency virus infection.
• Bitot's spot: White, foamy area of keratinising squamous metaplasia of bulbar conjunctiva,seen in vitamin A deficiency.
• Brushfield spot: Whitish grey spot in peripheral iris,seen in Down's syndrome.
• Elschnig spot: Yellow patches overlying area of choroidal infarction in hypertension.
• Fischer-Khunt spot: Senile scleral paque,area of hyalinised sclera anterior horizontal rectus muscle insertion. Seen in old age.
• Foster Fuch's spot: Pigmented (RPE hyperplasia) macular leisons in pathological myopia.
• Gunn's dot: light reflectios from internal limiting membrane around disc and macula
• Horner-Trantras Dot: Collections of eosinophils at limbus in vernal conjunctivitis.
• Kayes' dot (Krachmer’s spot): subepithelial infiltrates seen in corneal graft rejection
• Mittendorf's dot: whitish spot at posterior lens surface,remnant of hyaloid artery.
• Roth spots: haemorrhages with white centres,seen in SABE, severe anaemia,collagen vascular disorders.
• Cherry red spot: Central retinal artery occlusion, Commotio retinae (Berlin’s oedema),Tay-Sachs’ disease, Niemann-Pick’s disease, Gaucher’s disease
• Cream-colored spots: The classic diagnostic feature of bird-shot vitiliginous chorioretinitis is cream-colored spots, often as large as 0.5 to 1 disc diameter, that are scattered throughout the fundus.
• Koplik’s spots: on conjunctiva in measles

- compiled & published by Dr Dhaval Patel MD AIIMS