Photobiomodulation in Combination With Topical Cyclosporine A or Tacrolimus

Inclusion Criteria: (1) Ocular Surface Disease Index (OSDI) score \> 13; (2) non-invasive tear film break-up time (NIBUT) \< 10 seconds; and (3) tear meniscus height \< 0.25 mm. Exclusion Criteria: (1) structural abnormalities of the eyelids; (2) active blepharitis; (3) corneal disorders that could interfere with study assessments, such as active corneal infections or corneal dystrophies; (4) active ocular allergy; (5) history of procedures for DED treatment within the previous 12 months, such as eyelid exfoliation, thermal eyelid therapies, light therapies, or quantum molecular resonance (QMR); (6) history of intraocular or laser ocular surgery within the past 5 years; (7) current use of topical antibiotics or anti-inflammatory agents; (8) diagnosis of systemic autoimmune disease; (9) contact lens wear; (10) pregnancy or lactation; and (11) inability to understand or provide informed consent.