Ocular Rosacea is a systemic disease related to the faulty functioning of the immune system. This means that there will be repeated flare-ups and frequent recurrences of the 'pink eye' condition it triggers. Systemic illnesses are best treated with  systemic means such as antibiotics. Because facial rosacea (red nose and cheeks) does not correlate with manifestations of ocular rosacea, such as pink eye or blepharitis (red eye lids) it is often underdiagnosed. This is particularly so because nonspecific conjunctivitis (pink eye) is indistinguishable from conjunctivitis triggered by ocular rosacea. This underdiagnosis has been confirmed by various scientific studies and can, unfortunately,  lead to suboptimal treatment of the red eye condition. Please also have a look at Insight 74712 Ocular Rosacea 2