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• Trajectory-based CT signs predict aerodigestive injury after penetrating neck trauma. • Surgery should be considered when trajectory extends into the infra-arytenoid aerodigestive tract. • Endoscopy or exploration should be considered when trajectory violates deep neck spaces. • This modified approach can decrease negative explorations and invasive diagnostic procedures.

Radiologists, with the help of CT and preoperative clinical data, can predict visual acuity after open globe injury.

Purpose of reviewThis article summarizes the pathophysiology of rheumatoid arthritis and common ocular manifestations that it is associated with: keratoconjunctivitis sicca, episcleritis, scleritis, and peripheral ulcerative keratitis.Recent findingsNewer biologic agents are being used to effectively treat rheumatoid arthritis and its ocular manifestations.SummaryThe eye is a frequent extra-articular site of inflammation in patients with rheumatoid arthritis. Ocular involvement can range from more benign conditions such as keratoconjunctivitis sicca and episcleritis, to potentially vision and globe-threatening diseases like scleritis and peripheral ulcerative keratitis. Clinicians should be aware of these ophthalmic manifestations and the various treatment options that are available. Coordination between ophthalmology and rheumatology is helpful in the treatment of these patients.

IMPORTANCE Big data studies may allow for the aggregation of patients with rare diseases such as uveitis to answer important clinical questions. Standardization of uveitis-related variables will be necessary, including the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes used to identify patients of interest. There are currently limited data on the uniformity of diagnosis mapping to ICD-10 codes for uveitis diagnoses among different health systems.OBJECTIVE To assess the degree of uniformity in mapping of uveitis clinical concepts to ICD-10 codes across health care systems using the same electronic health record (EHR) system. DESIGN, SETTING, AND PARTICIPANTSThis multicenter survey study was conducted between September 14 and October 9, 2020, at 5 academic health care systems that use the Epic EHR.

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Background/Aims Numerous processes have been implicated as causes of punctal stenosis. Recent studies have highlighted inflammation in punctoplasty specimens in patients with punctal stenosis. Conjunctival biopsy has been suggested as a means to determine underlying etiologies, although little is known regarding what conjunctival pathologies are associated with punctal stenosis. Our objective is to examine the pathologic and immunologic findings in conjunctival biopsy specimens in patients with presumed idiopathic punctal stenosis. Methods A retrospective chart review was performed at a single institution over a five year period of patients with presumed idiopathic punctal stenosis who underwent conjunctival biopsy for routine histopathologic and/or direct immunofluorescent (DIF) examination. Patients with known etiologies of punctal stenosis were excluded. Results 23 patients met inclusion criteria. Conjunctival biopsies (n = 36) from all 23 patients underwent histological examination. 35 of 36 specimens (97.2%) showed a lymphocytic infiltrate. Two patients (8.7%) had findings suggestive of sarcoidosis. Conjunctival biopsies from 18 of the 23 patients were also evaluated by DIF. Nine patients (50.0%) had fibrinogen characteristics suggestive of lichen planus. There were no complications related to the conjunctival biopsy procedures. Conclusion Conjunctiva appears to be an excellent proxy in the evaluation of patients with presumed idiopathic punctal stenosis. The biopsy is safe and provides ample tissue. 11 of the 23 patients in this study demonstrated findings consistent with underlying immunologic disorders, suggesting that conjunctival biopsy may play a role in identifying the underlying etiology of punctal stenosis. Knowledge of these underlying conditions impacted medical and surgical treatments for several patients.