Eyelid Androgen Treatment in Dry Eye

Inclusion Criteria: * Moderate to severe dry eye (TBUT \< 6.0 seconds, corneal staining \> grade 1.5, evidence of meibomian gland secretion compromise or Schirmer \< 5 mm wetting in 5 minutes) * Age over 18 * Mild ectropion * Previous contact lens wearers IF no wear for prior 6 months * Punctal plugs if more than three months since placement * Systemic tetracyclines, antihistamines if consistent dosing * Sjogren's syndrome and related autoimmune conditions can be enrolled * Patients using topical dry eye treatments (e.g., Restasis) if willing to discontinue for 30 days Exclusion Criteria: * If artificial tears or autologous serum used on day of study * Ocular surgery if less than 12 months * Punctal plugs if within 3 months of plug insertion * Contact Lens wear within the six months prior to study * PSA levels greater than 4 ng/ml or BPH * Recent or current thrombolism * Recent or current cardiovascular events (e.g., MI, stroke) * Recent or current liver disorders * Concurrent use of topical medications; e,g., topical glaucoma medications * Diabetics * Females of child-bearing age if not on reliable birth control * History of breast cancer * Cannot be taking insulin, warfarin or systemic corticosteroids