Tear film comprises three layers: aqueous, mucin, and lipid.

Meibomian Gland Deficiency (MGD) causes a reduction in the lipid
(oily) layer of the tear film.  This leads to evaporative dry eye
(short TBUT -- or Tear BreakUp Time).  This is tear QUALITY.  It IS
quite possible, based on your description, that this is what you have,
but it's relatively easily diagnosed by a qualified dry eye doc.

Aqueous deficient dry eye (lacrimal gland insufficiency) leads to low
Schirmer's test scores.  This is tear QUANTITY (largely).

Damage to, or dysfunction of, the goblet cells leads to decreased
mucin production.  This, too, can cause evaporative dry eye.  This is
tear QUALITY.

There are all kinds of dry eye.  Restasis CAN be useful, primarily in
aqueous deficient (quantity) issues, but is certainly far from a
guaranteed fix.

My best recommendation would be to visit:

  www.dryeyezone.com

Review the introductory material, read the FAQ's, and browse around a
bit.  Then join the forum and talk with all of the DES sufferers
there.  They're a good bunch.

Tell 'em Neil sent you ;-)

Take care....

Neil

The problem may be excess or too thick oil from the meibomian glands
or not enough mucin produced by goblet cells in conjunctiva.   Oil
interferes with the mucin so that the tears don't "stick" to the eye;
solution to the problem is to remove oil or increase mucin.
Inflammation of the lids leads to increased oil release, inflammation
of eye leads to goblet cell malfunction and loss of mucin.

The warm compresses and lid scrubs address the excess oil.  Restasis
decreases inflammation and addresses the oil quality, mucin quantity
problem; it also takes 3-6 months for the full effect of Restasis to
be felt so it may be too soon to tell if it is helping.

To test whether Restasis is helping, you will need to take it for
about 6 months, then discontinue for at least 3 months and note the
difference.

Dr Judy