for people ages 18 years and up (full criteria)
at San Francisco, California
study started
estimated completion
Principal Investigator
by Julie Schallhorn, MD, MSThuy Doan, MD, PhD
Headshot of Julie Schallhorn
Julie Schallhorn
Headshot of Thuy Doan
Thuy Doan



This study aims to elucidate the effectiveness of oral azithromycin in treating symptomatic dry eye syndrome secondary to Meibomian gland dysfunction.

Official Title

A Randomized, Controlled Trial to Evaluate the Role of Oral Azithromycin in the Treatment of Symptomatic Meibomian Gland Disease and Its Effect on the Ocular Surface Microbiome


This is a randomized, placebo-controlled, double masked trial of the effectiveness of oral azithromycin in treating symptomatic dry eye syndrome secondary to Meibomian gland dysfunction. Dry eye syndrome (DES) is a persistent feeling of ocular discomfort that encompasses dryness, irritation, foreign body sensation and burning. In the United States, it is the most common non-refractive cause of visits to eye care providers, and has been shown to have a significant impact on quality of life of patients who suffer from this condition. most common cause of DES is Meibomian gland disease (MGD). In the vast majority of cases, MGD is not binding, but rather causes persistant ocular discomfort.

Oral antibiotics, particularly the tetracyclines and macrolides, are frequently prescribed for the treatment of MGD. There is little good-quality evidence to support this practice. This study is designed to evaluate the effectiveness of oral azithromycin on patient-reported dry eye symptoms. Concomitantly, we will also study the composition of the ocular surface microbiome in MGD, and its response for oral antibiotics.


Dry Eye, Neuropathic Eye Pain, Ocular Microbiome, Depression, Anxiety, Eye Pain, Meibomian Gland Dysfunction, Azithromycin, Azithromycin Oral Product


You can join if…

Open to people ages 18 years and up

  • Symptomatic Meibomian gland disease, defined as patient-reported ocular surface symptoms such as dryness, grittiness, foreign body sensation, or eye fatigue in combination with clinically identifiable Meibomian gland disease with Grade 2 or greater involvement on the Meibomian Gland Grading Scale (Section XV, item 2).
  • OSDI Score greater than or equal to 20
  • Ability to give informed consent

You CAN'T join if...

  • Age less than 18 years
  • Allergy or intolerance to oral azithromycin or topical dexamethasone
  • Allergy or intolerance to the preservatives used in topical ophthalmic 0.1% dexamethasone: sodium bisulfite, phenylethyl alcohol, benzalkonium chloride
  • History of prolonged QT interval, history of torsades des pointes, congenital long QT syndrome, bradyarrhythmias, heart failure
  • Patients currently taking medications that prolong the QT interval (Table 1)
  • Aqueous deficiency dry eye defined as Schirmer's strip testing without anesthesia with £ 5mm of tears on two separate tests.
  • Ocular surface inflammatory disease, including cicatrizing conjunctivitis, graft versus host disease, Stevens Johnson syndrome
  • Atopic disease with ocular involvement
  • Limbal stem cell deficiency
  • Oral or topical ophthalmic antibiotic use within the last 90 days
  • Oral prednisone use >5mg per day
  • Topical ophthalmic steroid use within the past 30 days
  • Topical ophthalmic anti-inflammatory (including non-steroidal anti-inflammatory medications, lifitegrast, or cyclosporine) use within the past 30 days
  • Patients who are currently pregnant, planning on becoming pregnant during the study period, or currently breastfeeding.


  • UCSF accepting new patients
    San Francisco California 94143 United States

Lead Scientists at UCSF

  • Julie Schallhorn, MD, MS
    Julie Schallhorn, MD, MS is Assistant Professor of Ophthalmology at UCSF. Dr. Schallhorn received her undergraduate degree in Chemical Engineering from UCLA, and her Master’s degree in Bioengineering from UCSD. She then completed medical training at the University of Southern California Keck School of Medicine, and her ophthalmology residency at UCSF.
  • Thuy Doan, MD, PhD
    Associate Professor, Proctor Foundation, Chancellor/EVC/FAS. Authored (or co-authored) 101 research publications


accepting new patients
Start Date
Completion Date
University of California, San Francisco
Phase 4 research study
Study Type
Expecting 40 study participants
Last Updated