WASHINGTON -- Necktie haters got a boost from science yesterday, as researchers branded that essential part of proper male business attire as the risk factor for a major cause of blindness.
They also reported that a tight necktie can tie knots in the diagnosis of glaucoma, making it seem as if people have the disease when they really don't.
"Glaucoma remains the leading cause of preventable blindness in the United States and is the second-leading cause of blindness," Dr. Robert Ritch noted in an interview. He is a New York Eye and Ear Infirmary ophthalmologist who headed the study being published in the British Journal of Ophthalmology.
"Our report will not change any social structures or graces, but if it makes people aware of the risk factor and [makes] physicians aware, then we will have succeeded in making a difference," Ritch said.
Glaucoma is a group of diseases caused by increased pressure of fluid naturally present inside the eyeball. Pressure rises when the fluid does not drain out of the eye normally. The pressure squeezes and damages the optic nerve, which carries visual signals from the eye to the brain.
Most people have no pain or other early symptoms. When finally diagnosed, they often have permanently lost some eye sight. Glaucoma can be diagnosed with a simple test that is part of most routine eye check-ups.
An estimated 4.2 million people age 40 and over have the most common form of glaucoma, and about 50 percent don't know it. Another 3 million to 6 million have elevated intraocular pressure, or IOP, which has not yet caused the actual nerve damage in glaucoma.
"Our paper demonstrates that a tight necktie could increase IOP, which remains the most important known risk factor for the development and progression of glaucoma," Ritch said. "Wearing a tight necktie during a routine examination could lead to an erroneous diagnosis of ocular hypertension or even glaucoma because the constriction would be causing an increase in IOP."
The risk is especially great in bigger men with thick necks, which may be severely constricted by both a necktie and a tight-fitting shirt collar, he added.
Neckties have the ill effect because they constrict the jugular veins, which run through the neck. Fluid from the eyes drains into the jugular veins, and squeezing them blocks the flow and raises the pressure.
Michael Woods can be reached at mwoods@nationalpress.com or 1-202-662-7072.
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