Inclusion Criteria:  Twenty-two (22) years of age or older BCDVA of 20/40 or better in each eye Both eyes with a baseline Schirmer's test with anesthetic ≤ 10 mm/5 minutes Presence of corneal staining in both eyes in any of the 5 areas defined by the NEI/Industry Workshop Scale Baseline OSDI score of at least 23 with no more than 3 responses of "not applicable" Patent bilateral lacrimal drainage system as demonstrated by punctal irrigation If female, subject must be post-menopausal, medically sterile (e.g hysterectomy, bilateral tubal ligation, bilateral oophorectomy) or have negative urine pregnancy test (UPT) on Day 0 of the study and agree to utilize a medically acceptable form of contraception over the course of the study Willing and able to sign informed consent and HIPAA authorization, follow study instructions, and complete all study visits.  Exclusion Criteria:  Use of ophthalmic cyclosporine (Restasis) within 6 months or lifitegrast (Xiidra) within 3 months prior to Day 0 in either eye History of surgical punctal occlusion (e.g., cautery), canalicular infection or canalicular surgery in either eye Corneal transplant in either eye Ocular surgery (such as cataract surgery or LASIK) in either eye within six months of the Baseline Visit A systemic condition or disease not stabilized or judged by the investigator to be incompatible with participation in the study (e.g. current systemic infection, uncontrolled autoimmune disease, uncontrolled immunodeficiency disease) The history or presence of any ocular disorder or condition in either eye that, in the opinion of the investigator, would interfere with the interpretation of the study results (e.g., significant corneal or conjunctival scarring, pterygium or nodular pinguecula; current ocular infection (except mild blepharitis), conjunctivitis or inflammation not associated with dry eye; anterior (epithelial) basement membrane corneal dystrophy or other clinically significant corneal dystrophy or degeneration; history of ocular herpetic infection; evidence of keratoconus; lid or lacrimal cancer Active severe systemic allergy, seasonal allergies, rhinitis or sinusitis requiring treatment (i.e., antihistamines, decongestants, oral or aerosol steroids) Use of steroids, including administration by systemic or topical ocular routes (dermatologic steroids not applied to the eyelids and inhaled steroids are allowed) Participation in a clinical trial during the past 30 days Women who are pregnant, planning a pregnancy, or nursing at study entry