Ocular rosacea, like regular cutaneous (skin) rosacea, is a condition of unknown cause.
In the case of rosacea and also blepharitis, various micro-organisms have been found in association with the condition. However, they have not consistently proven to be the cause for various reasons, such as not all patients having the particular micro-organism and, on the other hand, treating/eradicating the particular micro-organism does not cure/help all patients with the condition.
The other thing to realise is that there is usually no 'cure' for the condition, in the sense that symptoms/problems can recur from time to time even after the eye seems to respond to initial treatment.
In the first instance, you need to see an ophthalmologist for your condition and consider a second opinion if the initial diagnosis and/or treatment is not helping. I find that sometimes the symptoms may be related to other co-existing problems like dry eyes, and that symptoms remain because these other problems are not adequately treated.
The first line of treatment for ocular rosacea/blepharitis is usually lid scrubs/hygiene with warm water +/- products such as lid wipes. If the eye is significantly inflamed, topical steroids (eyedrops/eye ointments) can help. If there is no difference in symptoms whatsoever, either the diagnosis needs to be reconsidered, or the dosage of topical steroids may need to be adjusted.
There are other treatments that target the potential causes of the condition. For example, oral antibiotics like Doxycycline aim to modulate the oily secretions as well as reduce the bacterial load on the skin. Topical Ivermectin cream aims to kill demodex mites. However, it is my experience, even if these medications are used, topical steroids are still useful if there is eyelid or eye inflammation and redness.
