Comparative Efficacy Study to Demonstrate the Non-inferiority of I-DROP® MGD Versus 2 Competitor Eye Drops in Managing Evaporative Dry Eye

Inclusion Criteria:

• Is at least 18 years of age and has full legal capacity to volunteer.

• Has read and signed an information consent form.

• Is willing and able to follow instructions and maintain the appointment schedule.

• Has dry eye disease as per the TFOS DEWS II definition with a clear moderate tosevere evaporative Dry Eye:

• OSDI ≥ 13

• And TBUT < 10 seconds

• And >5 spots of corneal fluorescein staining OR > 9 conjunctival spots

• Meibomian Gland score of 1 or higher using NEI grading criteria.

Exclusion Criteria:

• Is participating in any concurrent clinical or research study.

• Is wears contact lenses.

• Is using any systemic medications that could impact the aqueous tear layer,including antihistamines, vitamin A analogues, phenothiazines, anti-anxiety drugs,antidepressants, and other medications with anticholinergic activity.

• Has undergone eye surgery involving the cornea or conjunctiva.

• Aqueous deficient DED patients.

• Is currently or has used any of the study drops in the last 3 months.

• Has any known allergy or intolerance to any of the study drops.

• Has any known active ocular disease such as allergies and/or infection or any oculardisease that in the opinion of the investigator may affect a study outcome variable

• Has a systemic condition that in the opinion of the investigator may affect a studyoutcome variable (e.g. uncontrolled autoimmune disease or uncontrolledimmunodeficiency disease).

• Has known sensitivity to sodium fluorescein.

• Is pregnant, lactating or planning a pregnancy at the time of enrolment?

• Unwilling to stop using their habitual artificial tears for the study.

• Has been fitted with punctal plugs within 30 days before the study screening visit.

• Contact lens users can still qualify for the study, however, participants shouldrestrain their contact lens use to a very minimum during the study duration.