Scleral lenses were all over the program at the Global Specialty Lens Symposium in Las Vegas (USA) a few weeks ago. Everything we know about the modality was shared from the podium. But - there are still many things we don't know. Take, for instance, the initial 'sinking' of the lens after fitting. We know a scleral lens sinks, but how much? Some pilot studies at Pacific University (Caroline, Kojima, So) have shown that on normal adolescent eyes over eight hours, the lenses tend to sink 50-200 microns - a huge range. And this can be even more significant with other lens designs and diameters (in this study only one lens design and diameter were used). In elderly patients things may be quite different as well, as the conjunctiva and Tenon's capsule (which is where we actually fit the lenses, not just the sclera) may typically get thinner with age. Hopefully we can get the resources and manpower together quickly to further evaluate the many fascinating aspects of scleral lens fitting. See also this hilarious video clip about 'sinking.' We have got a lot to think about.