Does wearing neckties cause glaucoma?

Question: Does wearing neckties cause glaucoma?

Answer: Wearing neckties alone does not cause glaucoma. However, in 2003, The British Journal of Ophthalmology published a study that showed that tightly worn neckties may temporarily increase the eye pressure measurement that your eye doctor takes during an examination. Increased intraocular eye pressure is a known risk factor for developing glaucoma. Glaucoma affects the optic nerve, the nerve cable that connects the eye to the brain. Glaucoma is caused by high pressure inside the eye or intraocular pressure (IOP.) It should be noted that simply having slightly increased eye pressure does not automatically mean that you have or will develop glaucoma. High IOP is only one risk factor for developing glaucoma.

Researchers have discovered that a necktie worn too tightly constricts blood vessels and increases pressure in the neck, head and eyes. This increased pressure is similar to what is called a valsalva maneuver, or increased pressure in the upper body and head caused by straining, bending over, coughing hard or holding your breath. Merely holding your breath when the eye doctor measures your eye pressure in the office can increase your eye pressure. Most physicians recommend relaxing and breathing normally during an eye exam and especially during the eye pressure measurement.

The 2003 British Journal of Ophthalmology study stated that a tight necktie can indeed increase eye pressure. What we do not know is how significant this temporary rise in eye pressure is and if it really contributes to one possibly developing glaucoma if they have other risk factors. The author of the study did summarize the following:

1. Wearing "too tight" of a necktie can temporarily cause a rise in eye pressure in susceptible individuals
2. Wearing a tight necktie should be considered a risk factor for increased eye pressure.

Wearing a tight necktie may affect a doctor’s ability to manage glaucoma effectively. Your eye doctor may consider wearing too tight of a necktie on a daily basis a "risk factor" for increased eye pressure and possibly developing glaucoma.

Personally, I have treated two patients in the past who had glaucoma and they had no other risk factors for the disease except that both appeared to wear what appeared to be very tight neckties on a daily basis. Should you stop wearing neckties? No, but if you tend to tie yours a little tighter than others or are slightly overweight and your shirt and necktie feel a bit too snug, it could potentially increase your risk for glaucoma by increasing the pressure inside your eye. If you can’t fit one or two fingers between your neck and your collar, it is probably a little too tight.

It is important to understand that higher eye pressure is simply a risk factor for developing glaucoma and does not represent actually having the disease itself. However, if you have other risk factors such as a family history, you should have an annual eye exam to be on the safe side.

_Source:

_{C Teng, Gurses-Ozden, R, Liebmann, JM, Tello,C, and Ritch, R. "Effect of a tight necktie on intraocular pressure." British Journal of Ophthalmology, 2003.}