Many association of DED metabolic traits have been already reported, in particular it has been highlighted a relationship between DED and serum steroids. Vehof et al. found a strong significant association between DED and decreased levels of some serum androgens, suggesting the use of androgens as a potential pathway for the treatment of DED . In fact, Bizzarro et al. proved that patients with DED and Sjögren syndrome showed a significant increase of tear volume in the Schirmer test and a decrease in the Bijsterveld score after oral testosterone undecanoate treatment with respect to placebo patients . A correlation between DED and serum steroids has been observed, but it is unknown if it is possible to confirm the same relationship with the tear steroids. This feature is exactly the starting point of our pilot study.