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The End Of The Tight Shirt Collar

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By The Shirt Doctor
tight collar medical studies

The Tight Necktie Syndrome

By Dr. W. Gifford Jones

December 4, 2004

A 55 year old businessman complained of headaches, blurring of vision and a tingling sensation in his right ear. Harvard professors failed to make a diagnosis. So he journeyed to the Mayo Clinic , then to a famous Harley Street doctor in London, England. But none could diagnose his problem.

Several years later he was at a convention in Atlantic City still suffering from these annoying symptoms. Having forgotten to pack enough shirts, he walked into an unremarkable men's store and asked for a size 15 shirt. A young salesman suggested a size 16.

Irritated, the man replied, "Look here, young man I've been buying shirts since you were in knee pants. I want a size 15". The salesman replied, "That's fine with me, sir, if you want to suffer from headaches, blurring of vision and a tingling sensation in your right ear".

This joke was circulating many years ago when I was a student at The Harvard Medical School. I wish we had been smart enough to realize the joke was on us. Thirty-five years later we now know that several medical problems are associated with tight clothing.

Dr. Susan Watkins at Cornell University reported in a study that there are two chances in three that the neck size of a man's shirt is too small and his necktie too tight.

The study involved 94 white-collar males. Researchers first measured the circumference of their necks with the collars buttoned and the ties knotted. The measurement was then repeated with the ties loosened and the collars unbuttoned. 67 percent were buying shirts with collars that were smaller than the size of their necks.

Dr. Watkins claims this is causing more than discomfort. It's also causing visual problems. Her conclusion was based on a test in which men were asked to tell the researcher when a light flickering at increased speeds appeared to be constant. The tight collar wearers were found to have poorer visual discrimination than those who purchased the right neck size.

Now another study published in the British Journal of Ophthalmology says that tight neckties increase the risk of glaucoma. Dr. Robert Ritch of the New York Eye and Ear Infirmary says a tight necktie constantly pressing on the jugular vein increases intraocular pressure (IOP) which is one of the leading risk factors in glaucoma.

This can even cause a false diagnosis of glaucoma if a tight necktie is worn during an eye examination.

Dr. Ritch examined 40 men, 20 with glaucoma and 20 without. The IOP was measured when each man wore a tight necktie and three minutes later after loosening the tie.

They discovered that 70 per cent of the healthy men and 60 per cent of those with glaucoma had increased IOP readings while wearing a necktie. Dr. Ritch claims this pressure day after day can predispose to glaucoma, eventual degeneration of the optic nerve and blindness. Today over 300,000 Canadians suffer from glaucoma.

It's unfortunate that the Nobel Prize has never been awarded for common sense in medicine. This IOP research may seem, on the surface, to be frivolous. But damage to the vital optic nerve because of a tight shirt or necktie is no laughing matter.

Tight clothing is simply not healthy. I've previously warned women about tight knee-high stockings and how these can cause varicose veins. But impeding the supply of blood to the brain is a greater hazard.

It may not be too long before researchers warn that tight shirts and ties can also injure carotid arteries, resulting in atherosclerosis and possible stroke. Or that tight clothing, by decreasing oxygen-carrying blood to the brain, may contribute to Alzheimer's Disease.

I'm grateful to doctors like Dr. Watkins and Dr. Ritch. I've always disliked tight shirts. That's why people often tell me I'm losing weight and should see a doctor. But I haven't lost or gained a pound for 30 years. And since I've always bought a larger neck-shirt I've never had to complain of headaches, blurred vision or a tingling sensation in my right ear!


W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He's been a ship's surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: He can be reached at

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