Efficacy of FreshKote and Systane for the Treatment of Dry Eye and Improvement of Osmolarity

Inclusion Criteria: * Dry eye patients with Level 2 disease or greater as defined by the Delpi Panel * Tear osmolarity of at least 308 mosm * At least 18 years of age, Male or Female * Willing to provide written informed consent * Likely to complete all study visits * If currently using ocular lubricants, must complete a 10-14 day washout Exclusion Criteria: * Presence of any active ocular disease other than dry eye * Use of topical ophthalmic medications * Use of contact lenses during the trial * Pregnant or nursing, or planning a pregnancy. Patients will be asked if they are pregnant or may be pregnant and excluded if they answer in the affirmative. * Any known sensitivity to any ingredients of either study drop * Oral anti-inflammatory medications, omega 3 supplements, or doxycycline * Punctal plugs inserted within the last 6 months or less * Uncontrolled systemic disease * Subjects with known sensitivity or inappropriate responsiveness to any of the medications used. * Acute or chronic disease or illness that would increase risk or confound study results (e.g., uncontrolled diabetes mellitus, immunocompromised, etc.) * Corneal abnormalities (e.g., ecstatic diseases, degenerations, or corneal dystrophies of the stroma or endothelium) * Concurrent participation or participation in the last 30 days in any other clinical trial