What is the most appropriate diagnosis for a 32-year-old male experiencing pain and an epithelial defect after previous corneal abrasion?

The diagnosis of recurrent corneal erosion is fitting in this scenario because the patient has a prior history of corneal abrasion, which can lead to recurrent episodes of pain and epithelial defects. Recurrent corneal erosion occurs when the epithelium does not adhere properly to the underlying basement membrane after an injury, such as an abrasion. This condition often presents with sudden onset pain and discomfort, especially upon awakening, as the eyelid may rub against the non-adherent epithelium during sleep.

In this case, the 32-year-old male's symptoms align with the characteristics of recurrent corneal erosion. The persistent nature of the epithelial defect, following an earlier injury to the cornea, suggests that the healing process did not occur optimally, leading to subsequent episodes of erosion.

While other conditions, such as corneal ulcers or ongoing abrasions, may present with similar signs, the specific history of a previous abrasion and the recurrent nature of the symptoms guide the diagnosis toward recurrent corneal erosion. Epithelial basement membrane dystrophy could also cause recurrent episodes but is differentiated by its more chronic presentation and absence of a clear prior traumatic incident.