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When Se deficiency occurs in the context of already existing hypothyroidism, the symptoms of myxedema (such as puffiness of the skin, a hoarse voice, and slowness of mental function) may become more pronounced [73]

Cell 23 , 21432155 (2012)

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Long-term treatment must be considered in addition to short-term medicines, taking into account the potential consequences of the artificial tears, anti-inflammatory eye drops, and punctal plugs are examples of conventional treatments for dry eye disease that can be successful, but long-term use can be costly and may result in adverse effects that limit patient adherence [38, 39]

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