Traditional Chinese Medicine Ultrasonic Atomization Treatment for Dry Eye Disease

Inclusion criteria:

1. At least one eye of subjects meets DED diagnostic criteria as the Tear Film andOcular Surface Society (TFOS) Dry Eye Workshop (DEWS II); and

2. Ocular Surface Disease Index (OSDI)≥13 and <33; and

3. The age range between years 18-80, no sex limitation; and

4. Symptoms of dry eye for at least 6 months; and

5. Can complete the questionnaires independently and understand Chinese or English.

Exclusion criteria:

1. Had or currently suffering from other concomitant ocular surface diseases, includingchronic conjunctivitis, ocular rosacea, cicatricial pemphigoid, graft-versus-hostdisease, limbal stem cell deficiency, and severe ocular allergy;

2. Received any refractive surgery and corneal surgery before, including cornealtransplant; or any eye surgery in the past 6 months;

3. Receiving DED-related medications, including topical steroid eyedrops, topicalantibiotics, topical cyclosporin A, and topical diquafosol;

4. Received intense pulsed laser (IPL) or vectored thermal pulsation (VTP) therapy inthe past 12 months;

5. Received topical antiglaucomatous treatment in the past 12 months

6. Plans to use contact lenses during treatment and follow-up periods or used contactlenses 2 weeks before the baseline measurement and recruitment;

7. Had or currently suffering from severe cardiopulmonary disease, liver and kidneydysfunction, and severe blood system diseases;

8. Suffering from glucose-6-phosphate dehydrogenase deficiency (G6PD);

9. Had or currently suffering from specific respiratory diseases, e.g. emphysema,bronchitis, asthma, chronic obstructive pulmonary disease, bronchial dilatation;

10. Has adverse reaction history to herbs used in this study before;

11. Whose TCM constitution is manifested as "yang-deficiency" or diagnosed by TCMpractitioners that their TCM syndrome is not suitable for the atomization treatment;

12. Pregnancy, preparation for pregnancy, or lactation;