New York-based experts say men who wear their ties too tight have increased intraocular pressure (IOP) – the most important known risk factor for the development and progression of glaucomatous damage.

The team reached their conclusions after examining 20 healthy males and the same number of men with open angle glaucoma.

IOP was measured when the men were wearing an open-shirt collar; three minutes after putting on a tight necktie; and three minutes after loosening the clothing.

Sixty per cent of men with glaucoma and 70 per cent of the healthy men experienced an increase in internal eye blood pressure after wearing a tight tie for three minutes – although there were no differences between the two groups before tie tightening and after loosening.

The problem could particularly affect men who prefer to wear their ties tight, those with thick necks and white-collar professionals, say the study’s authors. In addition, a tight tie can confound accurate IOP measurement, they argue.

For example, if the patient is wearing a tight tie when having his IOP checked, the clinician could inadvertently diagnose ocular hypertension or misinterpret the risk for disease progression.

So, although the pressure increase is real, it would not have been present if the patient had not had the constriction around his neck, they say.

The authors’ theory is that tight ties constrict the jugular vein, causing “elevated venous pressure and thus elevated episcleral venous pressure, in turn elevating IOP”.

“A tight necktie increases IOP in both normal subjects and glaucoma patients and could affect the diagnosis and management of glaucoma,” say the authors.

Source: British Journal of Ophthalmology

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