Eyelash Prostheses Compared to 5.0% Lifitegrast BID for Dry Eye Disease.

This is a single center, randomized, controlled clinical trial to evaluate the tolerability,
efficacy, and safety of eyelash prostheses over a 3-week period versus Xiidra BID over a 5
week period in subjects with self-reported DED. 40 subjects will be randomized to either
eyelash prostheses or Xiidra, in a 1:1 ratio.

At Visit 1 (screening), informed consent will be obtained from subjects and eligibility will
then be determined. All pre-treatment assessments will be done at this visit. Randomization
will occur. If randomized to receive Xiidra eye drops, a prescription will be written and the
treatment will be started right away. If randomized to eyelash prostheses, then a second
study visit will be made approximately 2 weeks later.

Visit 2 (Eyelash Prostheses application) Subjects randomized to receive eyelash prostheses
will have them applied approximately 2 weeks after the screening and randomization visit.

Visit 3 (Final visit) will be 3 weeks post eyelash prosthesis placement and 5 weeks post
Xiidra eye drop initiation. This was done to compare the maximal treatment effect between the
two groups. All subjects will undergo post-treatment assessments.

At each visit, patients will be asked to report any adverse events.

Inclusion Criteria:

1. Self-reported dry eye symptoms

2. Tear Break Up Time of less than 10 seconds as assessed by the Oculus Keratograph (see
Appendix A).

3. SPEED II Score greater than 25

4. Men or Women, age between 50 and 90 inclusive

5. Willingness to undergo both pre-treatment and post-treatment testing per the protocol

6. Willingness to endure the 2-3 hour time required to place eyelash extensions, if
randomized to this treatment arm

7. Willingness to use eye drops for dry eyes and fill a prescription through insurance
coverage, if randomized to this treatment arm

8. Willingness to attend all study visits

9. Willingness to sign informed consent and liability waiver

Exclusion Criteria:

1. Absence of eyelashes

2. Eyelash disease such as clinically significiant demodex, blepharitis, meibomitis

3. Be unable or unwilling to give written informed consent and/or to comply with study
procedures.

4. Have any known hypersensitivity or contraindication to study treatments (including
excipients), topical anesthetics or vital dyes.

5. Be unable to demonstrate correct instillation of over the counter (OTC) ocular
lubricant during Visit 1.

6. Have clinically significant ocular surface disease in either eye (e.g., corneal edema,
uveitis, severe keratoconjunctivitis sicca) which might interfere with study safety
procedures, or assessments.

7. Have clinically significant systemic disease (e.g., uncontrolled diabetes, hepatic,
renal, endocrine or cardiovascular disorders) which might interfere with the study at
Visit 1 and 2.

8. Current use of Restasis or Xiidra at the time of Visit 1

9. Changes in the dose of, or the initiation of, any medications that are known to affect
dry eyes within 90 days of Visit 1 or during the duration of the study.

10. Any history of Herpes simplex of Herpes zoster affecting the eye or head.