Primary prevention
Primary prevention involves reduction of environmental factors that have been associated with idiopathic optic neuritis (ON) and multiple sclerosis (MS). Of these, avoidance or cessation of smoking and adequate vitamin D exposure in childhood are important and represent preventive measures for a variety of conditions.[15][16] The "hygiene hypothesis" postulates that early exposure to a variety of infectious agents may prevent development of autoimmunity and asthma/allergy.[18] Although the evidence for the hygiene hypothesis applying to ON/MS is not strong, it is known that early primary Epstein-Barr virus exposure is usually asymptomatic and later exposure has a higher risk of being symptomatic. It is later primary exposure that has been linked with MS/ON.[13]
Secondary prevention
There are no clear preventive measures. Patients need to ensure an adequate intake of vitamin D. Patients with MS are encouraged to give up smoking and to receive influenza vaccinations in seasons deemed appropriate, as influenza infections and smoking are risk factors for MS.
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