The COAT Trial: Cequa's Onset of Action Trial

Inclusion Criteria:

*Patients with the following signs: Central or inferior corneal fluorescein staining defined by the Oxford Scale Reduced tear break up time (TBUT) ≤ 10 seconds.

• Able to comprehend and sign a statement of informed consent.

• Willing and able to complete all required postoperative visits.

Exclusion Criteria:

• Ocular surgery (e.g., intraocular, oculoplastic, corneal, or refractive surgicalprocedure) performed within the last 3 months or at any time that in theinvestigator's clinical judgment if it would interfere with the outcome measures ofthis study.

• Clinically significant ocular trauma.

• Active ocular Herpes simplex or Herpes Zoster infection

• Ocular inflammation (uveitis, iritis, scleritis, episcleritis, keratitis,conjunctivitis) at the discretion of the investigator.

• Ocular infection (e.g., viral, bacterial, mycobacterial, protozoan, or fungalinfection or the cornea, conjunctiva, lacrimal gland, lacrimal sac or eyelidsincluding hordeolum/stye).

• Active, systemic, or local disease condition that causes clinically significantocular surface irritation such that it could interfere with the study findings.

• Moderate to severe (Grade 2-4) allergic, vernal or giant papillary conjunctivitis.

• Severe (Grade 3 or 4) inflammation of the eyelid (e.g., blepharochalasis,staphylococcal blepharitis or seborrheic blepharitis)

• Eyelid abnormalities that significantly affect the lid function (e.g., entropion,ectropion, tumor, edema, blepharospasm, lagophthalmos, severe trichiasis, severeptosis).

• Ocular surface abnormality that may compromise the corneal integrity (e.g., priorchemical burn, recurrent corneal erosion, corneal epithelial defect, Grade 3 cornealfluorescein staining, map dot fingerprint dystrophy, or the effect of any otherophthalmic medication that might in the opinion of the investigator compromise theocular surface integrity).

• Participation in this trial in the same patient's fellow eye

• Patients who are under age 18, pregnant or breastfeeding, or who may become pregnantduring participation in the study.