The ocular manifestations of rosacea are commonly nonspecific and variable. The etiology of the inflammation is unknown and there is no diagnostic test for the disease. Ocular rosacea is often underdiagnosed, despite the potential for serious sight-threatening sequelae. When evaluating patients with rosacea, dermatologists should obtain a careful history of eye complaints and examine the eyelid margins thoroughly. Treatment is aimed at controlling symptoms and is multifaceted. The foundation of treatment is good lid hygiene and oral tetracyclines. Those patients with moderate-to-severe ocular findings will benefit from a multidisciplinary approach, including evaluation by an ophthalmologist.