Tics that bind the neck may raise the risk I of the eye disease glaucoma. A controversial study found that snug neckwear can increase intraocular pressure (IOP) in the eyes, possibly leading to glaucoma.

"If men wear tight neckties when their IOP is measured, it can raise their IOP," says Dr. Robert Ritch, lead author of the study and a professor of clinical ophthalmology at The New York Eye and Ear Infirmary.

DOUBLE TROUBLE

That double Windsor knot may be double trouble. If a person has moderate or severe glaucoma damage, the increase in IOP caused by a tight tie may worsen the damage. What's more, patients without glaucoma whose tight tie falsely increases IOP might end up being treated for glaucoma when they don't need to be. Although there are no reported cases of glaucoma being caused by a tight necktie, Ritch says it's theoretically possible.

Ritch became aware of the phenomenon during his regular practice. "I just noticed that some patients had tight neckties, and I just loosened their neckties and their IOP would go down several points," he says.

To quantify his observation, Ritch and his colleagues looked at 20 healthy men and 20 men with open-angle glaucoma, the most common form of the disease.

The researchers measured IOP first while the men weren't wearing neckties, then three minutes after they put on a tight necktie, and again three minutes after the tie was loosened.

Ritch's team found that in 70% of the healthy men, a tight necktie increased mean IOP, as it did in 60% of those with glaucoma.

Increases in IOP while wearing a tight necktie ranged from more than 2 to more than 4 mmHg (millimeters of mercury), compared with IOP readings when no ties were worn and after ties were loosened.

Ritch speculates that when a necktie exerts too much pressure on the jugular vein located in the neck, pressure is increased in the entire venous system, including in the eyes.

To learn more about glaucoma, visit the Glaucoma Research Foundation's Web site at uww.glaucorna.org.

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