Both soft and hard exudates are seen in -

Ans. is 'd' i.e., All of the aboveCauses of soft exudates (cotton wool spots)o All types of severe hypertension (hypertensive retinopathy) including renal disease, Toxemia of pregnancy,o Diabetic retinopathyo Collagen vascular disorders SLE, PAN, systemic sclerosis, scleroderma, wegener granulomatosis,o InfectionsAIDS, septic retinitis (including SABE), rarely CMV retinitis in AIDS,o Microembolization IV drug abuse, Post cardiac surgery, Fat embolism or Purtscher retinopathy,o OtherEale's disease, Adults anemia (Hb < 6.6-8.0 g/dl), Pseudoxanthoma elasticum, Neoplasia (Leukemia, Hodgkin's disease), Sickle cell retinopathy, radiation retinopathy.Causes of Hard exudateso Sever hypertension (Hypertensive retinopathy), especially with renal diseaseo Diabetic retinopathy, especially with renal diseaseo Infections :- Measles, influenza, meningitis, erysipelas, psittacosis, parasitic infection, coccidioidomycosis, condidiosis, TB, syphilis.o Collagen vascular diseases :- Dermatomyositis, SLE, PAN, Bechet's syndrome, Systemic sclerosis, Rheumatic polyarthritis.o Hematological :- Pernicious anemia, other severe adult anemia (Hb < 8 g/dl), leukemia, multiple myeloma.o Eye diseases :- Disciform macular degeneration, Coats disease, Eales disease.o Othercerebral trauma, after strangulation, fat embolism, lead poisoning, sarcoidosis, old central retinal vein thrombosis, Retinal artery macroaneurysm, Choroidal neovascularization, Hypercholesterolemia.o Two important facts require specific mention here :-Severe hypertension of any type (including toxemia of pregnancy) can cause soft exudate. On the other hand severe hypertension associated with renal disease causes hard exudate (not toxemia of pregnancy).Diabetic retinopathy, hypertensive retinopathy, Eale's disease and collagen vascular disease can cause both soft and hard exudates.