AS A CHILD I WAS VERY curious. Unfortunately, adults kept on challenging my curiosity, in an attempt to run away from giving explanations by making what I can now consider to be frivolous statements. My attempts to investigate the veracity of such statements and find out how things worked often led to damage or destruction of some properties. I left many ‘casualties’– battered toys, watches, wall and table clocks with the back plates ripped off, as evidence of my curiosity and earned several spankings for these. I also tried several experiments, such as checking what happened to boiling crabs while on fire. On one occasion, the pot turned over and boiling water splashed on my legs. Thanks to mom who nursed the ulcers which left some hideous and indelible scars on my legs.

When eventually, the radio and later the television came along, they weren’t spared. I dismantled them to find out what it was that was talking inside them. Quite often because of inappropriate tools, I wasn’t able to put them back.

By and large, the most formidable challenge I faced was understanding the clock. Having opened many boxes and having convinced myself that there was a system of pulleys rotating and moving the clock’s hands, I still found it difficult to understand the relationship between the movements and the time of the day. Encyclopaedias the only source of information - our yesteryears equivalent of today’s Internet - gave me some ideas which often increased my curiosity. A unique opportunity came my way when I was made the school’s Time-keeper in my third year in Primary School. My very first action was to move the hour hand from the 12o’clock position to 2to see its effect on the day’s outlook. Since lessons ended at 2pm, I rang the bell signifying the close of the day’s session. The headmaster and all the teachers ran up to me, snatched the bell from me and tongue-lashed me. I really couldn’t understand what all the hues and cries were about. That incidence ended my tenure as the time-keeper.

The clock for me has however remained an enigma and the eye, is to me, even more its intriguing replica. The mysteries of the eye for me are nevertheless, like the clock in those days and still mind boggling. But now I am restrained and cannot, as a surgeon, treat it like I used to treat the clock. It must be handled purposefully with dexterity and utmost care.

The link between the two nevertheless remains strong. We often describe a lesion on the surface or inside the eyeball by the face of the clock. The tiny nodular gelatinous swelling at 9 o’clock at the junction of the black (actually clear and transparent cornea) and white of the eye (sclera)is called the Pinguecula. Its more prominent, fleshy and wing-like or triangular looking counterpart with the apex at the cornea is called the Pterygium. Both are absent at birth and are only occasionally seen before the age of 20. The Pinguecula is harmless and does not affect vision. The Pterygium, on the other hand, is often unsightly and in its advanced stage may interfere with vision either by distortion of the cornea or by encroachment on the corneal surface.

What causes pterygium? Not all is known about the cause. It is well known that pterygium is found in the tropics and rarely in temperate climates except in people who had lived in the tropics before moving to the temperate regions. Thus the ultra-violet rays of the sun and chronic irritation from dusts– common features of the tropics - have been implicated. But like I found, as a child, relating the physical clock to the changing daylight hours, there are still questions to be answered. Why is it unusual in children? Why does it occur in one eye and not the other? Why does it occur in some people and not in others who are exposed to the same environmental hazards? These are some of the questions waiting to be answered. Our country is in the pterygium belt (latitude 40 degrees North and South of the equator). and the answers must come from us. Is there anyone out there ready to support our quest for unravelling the mystery of pterygium? Knowing the answers will help us treat the condition better and perhaps more importantly, prevent its occurrence. Nearly 6 out of every 10 cases recur after surgical removal. To reduce the recurrence, we have had to develop new procedures and adjunctive therapies.

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