Efficacy and Safety of Topical Hydrocortisone on Signs and Symptoms of Dry Eye Associated to Meibomian Gland Dysfunction

Inclusion Criteria:

1. Age ≥ 18 years
2. Documented diagnosis of DE defined by TBUT value ≤ 5 seconds and Schirmer I test value < 10 mm/5 min
3. Normal ophthalmic findings except dry eye disease and meibomian gland dysfunction
4. OSDI score > 23 (moderate symptoms)
5. Documented diagnosis of MGD grade 2 to 3
6. Patient who can understand the instructions and adhere to medications
7. Patient who receives complete information regarding the study objectives, authorizetheir participation in the study and sign an informed consent form before entering inthe study

Exclusion Criteria:

1. Any contraindication or known allergies to Lephanet®, Thealoz Duo®, MGD Rx EyeBag® orSoftacort®
2. Ocular surgery in the past 6 months
3. Ocular hypertension or glaucoma
4. Cicatricial MGD
5. Atopic condition including ocular allergy
6. Suspect demodex lid infestation as evidenced by the presence of collarettes
7. Intraocular inflammation
8. Confirmed infection with COVID-19 in the last 3 months
9. Systemic autoimmune disorder
10. Use of contact lenses during the month prior to inclusion in the study or during thestudy
11. Punctal occlusion
12. Intraocular pressure > 22 mmHg
13. Patient who has received topical or systemic anti-inflammatory treatments includingcorticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDS) within 3 monthsprior to be included in the study or with a prescription for receiving topical /systemic anti-inflammatory treatments for the next 3 months
14. In the investigator´s opinion, use of systemic medications that could affect thefunction of the meibomian gland and tear production within 3 months prior to beincluded in the study
15. Any ocular or systemic disease known to affect the tear film other than MGD
16. Patient with any situation or state that in the opinion of the investigatordiscourages their participation in the study
17. Patient participating in any other interventional or non-interventional study or whohave participated in another study within 30 days prior to inclusion in this study
18. Women who are pregnant, planning to become pregnant or breastfeeding
19. Patient who will not be able to complete the study (e.g., not willing to attend thefollow-up visits, way of life interfering with compliance)