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A 31-year-old woman with a history of unusual appearing recurrent linear corneal epithelial defects and subepithelial scaring in both eyes underwent 2 years of evaluation and treatment. It was eventually discovered that the patient was using a sleep mask with excessive fabric pilling, which was found to be the source of her chronic epitheliopathy. After discontinuation of the sleep mask, the patient experienced complete resolution of symptoms. When evaluating recurrent corneal epithelial defects, external sources of repeated trauma, including sleepwear, should be investigated.