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The observed improvement in tear film stability, as measured by TFBUT, is particularly relevant given G-OSD is predominantly associated with Meibomian gland dysfunction (MGD), leading to an evaporative form of DED characterized by poor tear film stability ( In our cohort, glutathione use was associated with reduced ocular surface damage, as indicated by NEI-SS scores

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If a genetic or metabolic cause is suspected, additional investigations may be needed