Efficacy of 0.05 % Cyclosporine Ophthalmic Emulsion Compare With Tear in Meibomian Gland Dysfunction

Inclusion Criteria: * Males or females, of legal age of consent * Patient has a diagnosis of meibomian gland dysfunction with at least 1 symptom as the following; ocular burning, ocular discomfort, and grittiness * Had a slit-lamp diagnosis of meibomian gland dysfunction based on the presence of one of the following * meibomian gland inflammation by lid margin or tarsal erythema, bulbar conjunctiva hyperemia, telangiectasia or thickening irregularity of the eyelid margins * meibomian gland orifice inclusion (plugging) or abnormal of secretion * Non-invasive tear break up time (NTBUT) with Tear scope Plus(Keeler, Windsor, UK) ≤ 8 seconds * Ability to follow study instruction and likely to complete all required visits Exclusion Criteria: * Age \< 18 years old * Patients with severe ocular disease from Steven Johnson syndrome burn, limbal deficiency * Patients used cyclosporine within past 1 year * Patients used oral cyclosporine or anticholinergic drug within past 2 months * Patients with HIV or autoimmune disease * Patients with active ocular infections and patients with a history of herpes keratitis * Patients with known or suspected hypersensitivity to any of the ingredients in the formula (cyclosporine, glycerin, castor oil, polysorbate 80, carbomer 1342) * Female patients are pregnant or nursing * Patients who wear contact lenses