A laser eye surgery system that has a patient interface between the eye and the laser system relying on suction to hold the interface to the eye, the patient interface using liquid used as a transmission medium for the laser. During a laser procedure sensors monitor the level of liquid within the patient interface and send a signal to control electronics if the level drops below a threshold value. The sensor may be mounted on the inside of the patient interface, within a fluid chamber. Alternatively, a gas flow meter may be added to a suction circuit for the patient interface that detects abnormal suction levels indicating low fluid level.