Dry eye disease can be classified into two types, aqueous deficient dry eye and evaporative dry eye. Aqueous deficient dry eye results from an insufficient aqueous layer of the tears. It is due to dysfunction of the lacrimal gland; this can be caused by certain medications, inflammatory disease, or certain auto-immune diseases such as Sjogren’s, rheumatoid arthritis, and systemic lupus erythematosus. Evaporative dry eye disease is caused by blockage and dropout of the meibomian glands, this can be due to bacterial biofilms and exotoxins, inflammation, or a diet lacking essential fatty acids. Rosacea is a chronic inflammatory disease that is also known to cause meibomian gland dysfunction and evaporative dry eye.