This is a corneal abrasion that recurs because it doesn’t “heal right,” kind of like a skin cut that keeps reopening. The cornea is the clear structure that lies at the front of the eye, forming the ocular surface that allows light to enter the eye. The cornea is relatively tough but it is covered by a more delicate layer of skin called the corneal “epithelium.” The corneal skin is thin and can easily rub or scratch off due to trauma or abrasion caused by a piece of sand in the eye. Surface scratches are called “corneal abrasions” and can cause much discomfort. A recurrent erosion occurs when the epithelial skin doesn’t heal well enough to the cornea. Repeated blinking can cause the corneal epithelium to scratch off again. This usually happens in the morning when the eyes are most dry. When the eyes pop open, the suction pulls off the epithelium again. This repetitive process can make the erosion take forever to heal. You can almost imagine that the surface epithelium is like a carpet that grows back over a concrete foundation. With recurrent erosion, the concrete gets “sandy” or “rough” in one spot such that carpet has a hard time tacking down in that particular area. Treatment for a recurrent erosion usually begins with aggressive night-time lubrication and ointments but can expand to include night-time patching and bandage contact lenses. If these aren’t working, more aggressive surgical treatments can be considered, such as polishing the underlying cornea with a diamond burr or stromal puncture (using a needle to create small divots in the cornea for the surface epithelium to grow down into and stick better).