Study to Determine the Effect of Azasite on Corneal Surface Irregularity

Inclusion Criteria: * Ability to provide informed consent prior to enrollment in study * Patient ability to follow study instructions and comply with all study protocols * Corneal irregularity measurement (CIM) \> 1.7 in both eyes * Non-atrophic meibomian gland dysfunction (MGD) as defined by abnormal meibomian expression in at least 2 meibomian glands of the eyelids of each eye * At least two symptoms of at least moderate severity (≥ grade 2, 0 to 3 scale) as defined in the MGD Global Symptom Score (Itching, Foreign-body sensation, Dryness, Burning, Lid swelling) * Tear film break up time \< 10 seconds * Schirmer with anesthesia \> 5 mm * Best corrected distance visual acuity (BCDVA) \> 20/100 Exclusion Criteria: * Cicatricial or atrophic meibomian gland dysfunction (MGD) * Any corneal disease or scar involving the central 6 mm, including epithelial basement membrane dystrophy, Salzmann nodular degeneration, recurrent erosions, keratoconus or ectasia * Use of azithromycin or doxycycline within 1 month of screening * Topical ocular antibiotic, anti-histamines, allergy, or steroid medication within 2 weeks of baseline (a 2 week washout after screening will be allowed) * Topical prostaglandin analogue use within 30 days of study * The anticipated use of any drops, gels or ointments during the study period outside of the study protocol * Use of eye make-up during study period * Active ocular infection or inflammation * History of herpetic eye disease or neurotrophic keratitis * Lid pathology (except MGD or blepharitis) that the examiner feels may affect the ocular surface * Significant conjunctival scars (ex. h/o SJS) * Pterygium * Lacrimal punctal occlusion within 2 months of screening * Ocular surgery within 1 year of screening * Monocular patients * Pregnant, breast-feeding, or sexually active females not using contraception * Uncontrolled systemic disease * Presence of any disease (medical or ocular) that, in the opinion of the investigator, may interfere with the study's safety or interpretation * Known allergy to the study medication or its components * Current enrollment in an investigational drug or device study within 30 days of screening for this study