PURPOSETo explore effects of topical 1% selenium sulfide on signs and symptoms in symptomatic contact lens-wearers, in an exploratory 4-month prospective placebo-controlled double-masked randomised trial.METHODSSymptomatic wearers (Contact Lens Dry Eye Questionnaire-8 [CLDEQ-8] score>12) with meibomian gland dysfunction (meibomian gland score (MGS)≤12), were enrolled and received either active (AZR-MD-001-containing 1% selenium sulfide), or vehicle ointment, to the lower eyelid margin twice-weekly. MGS, meibomian glands-yielding liquid secretion (MGYLS), lipid layer thickness, tear meniscus height, tear break-up time, tear evaporation rate, lid wiper epitheliopathy, CLDEQ-8 and comfortable wear time (CWT) were measured at baseline and to 4-months. Differences between active and placebo were compared to baseline.RESULTSFourteen participants (5M:9F, 30.8±13.8 years) completed the study. In the active group, change in MGS from baseline improved by 1-month (mean difference 7.9±8.0, p=0.03), to 4-months (16.0±11.3, p<0.01). MGYLS improved from baseline by 1.5-months (4.0±3.3) to 4-months (4.1±4.3, p<0.01). In the vehicle, change in MGS (12.1±10.7) and MGYLS (3.9±3.2) were improved at 4-months only (p<0.01). CLDEQ-8 score improved at 1-month and 4-months compared to baseline (-4.4±3.2, -5.1±4.7, p≤0.02) in the active and at 4-months only in the vehicle group (-4.4±6.4, p=0.02). In the active group, CLDEQ-8 visual function scores improved at 1- and 4-months (p ≤ 0.02) and CWT at 4-months (median 7 vs.10 hours, p=0.025). Other signs were unchanged.CONCLUSIONSThis exploratory study indicates that twice-weekly use of AZR-MD-001 ointment can rapidly improve gland patency and secretion in symptomatic contact lens-wearers. AZR-MD-001 reduced changeable/blurry vision and prolonged CWT, suggesting relevant future endpoints.