Sight Sciences (SGHT) Q1 2026 Earnings Transcript

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DATE

Wednesday, May 6, 2026 at 4:30 p.m. ET

CALL PARTICIPANTS

Chief Executive Officer — Paul Badawi
Chief Financial Officer — Jim Rodberg
Chief Operating Officer — Alison Bauerlein

TAKEAWAYS

Total Revenue — $19.7 million, representing a 13% increase, driven by growth in both Interventional Glaucoma and Interventional Dry Eye segments.
Interventional Glaucoma Revenue — $18.3 million, up 7%, with ordering accounts rising 6% and average selling prices higher, partially offset by lower utilization per account.
Interventional Dry Eye Revenue — $1.4 million, nearly doubling from $400,000, with over 1,500 SmartLids sold, utilization per active account rising from 9 to 16, and sales to 96 accounts.
Gross Margin — 86% overall; Interventional Glaucoma at 87%, flat, while Interventional Dry Eye increased to 72% from 71%, primarily on higher selling prices and product mix shifts.
Operating Expenses — $29.4 million, up 2%; excluding a $5.4 million litigation fee, operating expenses declined 17%, with adjusted operating expenses at $21.2 million, down 14%.
Net Loss — $13.0 million ($0.24 per share), narrowing from $14.2 million ($0.28 per share).
Cash Position — $85 million in cash and equivalents, with $7 million utilized in the quarter, a decline from $11.6 million utilized previously.
Debt — $40 million (excluding unamortized discount and issuance costs) at quarter finish.
Patent Litigation Judgment — Final court judgment upheld $55 million in damages and 10% ongoing Hydrus royalties from Alcon; no cash received yet and subject to appeal.
2026 Revenue Guidance — Raised to $83 million-$89 million (7%-15% increase), including $77 million-$81 million for Interventional Glaucoma (2%-7%) and $6 million-$8 million for Interventional Dry Eye.
2026 Adjusted Operating Expense Guidance — Reaffirmed at $93 million-$96 million, a 6%-9% increase, mainly for tarreceiveed commercial growth investments.
Q2 2026 Outview — Total revenue expected to grow low double digits; Interventional Glaucoma to increase mid-single digits; Interventional Dry Eye revenue in the $1.5 million-$2 million range.
Commercial Execution — Expanded sales and clinic support teams in Interventional Dry Eye, intensifying focus on First Coast and Novitas regions with newly established reimbursements.
Market Access — Management stated, “We expect additional payers to establish fee schedules this year” for TearCare, following ongoing engagement with MACs and commercial payers.
Operational Strategy — “We believe procedural options can play a larger role in the treatment paradigm” and highlighted the “intersection of intervention” as central to growth and customer penetration efforts.
New Product Pipeline — OMNI Ultra is tarreceiveed to launch upon anticipated FDA 510(k) clearance by year finish, with guidance excluding any OMNI Ultra contributions.

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RISKS

Final judgment in the Alcon patent litigation, totaling $55 million in damages and future royalties, remains subject to appeal, and “no cash has been received to date.”
Interventional Glaucoma revenue growth was “partially offset by lower utilization per account,” suggesting variability in per-account procedure volumes.
Expansion of TearCare remains depfinishent on additional payer fee schedules, as management confirmed current guidance assumes only the First Coast and Novitas reimbursements.

SUMMARY

The call demonstrated Sight Sciences, Inc. (NASDAQ:SGHT) raised revenue expectations for the year amid accelerating revenue and margin progress across its two main segments. Management reported heightened commercial activity, citing cross-segment synergies and a scalable business model, while outlining specific reimbursement expansion initiatives underway that could influence future results. Leadership stated no impact from the OMNI Ultra product in its current guidance and described continued expense discipline aimed at positioning for cash flow breakeven without new equity capital. The company also affirmed an unmodifyd adjusted operating expense outview despite increased investment in commercial infrastructure to support scale.

Management declared, “guidance only takes into account First Coast and Novitas fee schedules in place for 2026,” emphasizing near-term Dry Eye growth is tied to current geographic reimbursement scope.
Leadership stated, “We believe there is meaningful customer and patient overlap in our two business units,” highlighting intentional cross-selling as a revenue driver.
Operating expenses would have revealn an even greater decline absent a $5.4 million litigation-related fee recognized this quarter.
Order growth for OMNI was explained as coming from both “reactivating dormant accounts and adding new accounts.”
Management described the Interventional Dry Eye opportunity as “very much in the early penetration days,” pointing to a large, underpenetrated market with only ~96 accounts activated so far in reimbursed territories.
OMNI Ultra was discussed as a differentiated new product, though management confirmed, “We have put out guidance that we are very confident we can deliver regardless of when Ultra arrives.”
The quarter’s cash usage ($7 million) fell sharply versus the prior period, providing management confidence to pursue growth initiatives within existing resources.

INDUSTRY GLOSSARY

MACs (Medicare Administrative Contractors): Regional private organizations that process Medicare claims and determine local Medicare coverage policies.
MIGS (Microinvasive Glaucoma Surgery): A class of surgical procedures designed to reduce intraocular pressure in glaucoma patients applying minimally invasive techniques.
SmartLids: Disposable applicators utilized with the TearCare System for the treatment of dry eye disease.
First Coast and Novitas: Specific regional MACs responsible for Medicare fee-for-service reimbursement decisions in designated U.S. states.
Combo Cataract Market: The segment of cataract surgery procedures where glaucoma interventions are performed simultaneously.
Hydrus: A competitor device referenced in patent litigation; subject to royalty claims per the court verdict.
OMNI Ultra: Next-generation OMNI Surgical System product in development, pfinishing FDA clearance.

Full Conference Call Transcript

Paul Badawi, and chief financial officer, Jim Rodberg. Also in attfinishance is Sight Sciences, Inc. chief operating officer, Alison Bauerlein. Earlier today, Sight Sciences, Inc. released financial results for the first quarter finished 03/31/2026 and raised its revenue guidance while maintaining its adjusted operating expense guidance for full year 2026. A copy of the press release is available on our website at investors.sightsciences.com. I would like to remind everyone that comments created by management today and answers to questions will include forward-viewing statements, including statements about material business considerations, 2026 outview, and financial guidance. These statements are based on plans and expectations as of today, which may modify over time.

In addition, actual results could differ materially from projected results due to a number of risks and uncertainties. For a discussion of factors that may affect the company’s future financial results and business, please refer to the earnings release issued prior to this call and the company’s most recent SEC filings. We undertake no obligation to publicly update or revise any forward-viewing statements, except as required by law. Also on this call, management refers to certain financial measures that were not prepared in accordance with generally accepted accounting principles in the United States, including adjusted operating expenses.

We believe these non-GAAP financial measures are important indicators of the company’s operating performance becautilize they exclude items that are unrelated to, and may not be indicative of, its core operating results. Please refer to our earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP financial measure, as well as additional information about our reliance on non-GAAP financial measures. I will now turn the call over to Paul.

Paul Badawi: Thanks, Hannah. Good afternoon, and thank you for joining us. We delivered a strong start to 2026, with first quarter results that demonstrated a return to double-digit revenue growth, continued strength in gross margin, and disciplined operating expense and cash management. We drove solid execution across both segments, Interventional Glaucoma and Interventional Dry Eye. This included the third quarter in a row of revenue growth in Interventional Glaucoma, and continued positive commercial traction in Interventional Dry Eye where revenue nearly doubled from the fourth quarter, representing early validation of our procedural, in-office, recurring-revenue business model. Based on our performance and outview, we are raising our full year 2026 revenue guidance while maintaining our adjusted operating expense guidance.

We are continuing to build an interventional eye care company focutilized on two significant anterior segment diseases—glaucoma and dry eye disease—where we believe procedural options can play a larger role in the treatment paradigm. Our two flagship technologies, OMNI and TearCare, are designed to address the root underlying cautilizes of disease and can efficiently integrate into established practice workflows. They each support our focus on earlier, procedure-based care, while assisting providers deliver consistent clinical outcomes for patients. We believe there is meaningful customer and patient overlap in our two business units, particularly in high-volume cataract and MIGS practices, where ocular surface disease is common and where physicians are increasingly incorporating procedural options in their treatment algorithm.

Glaucoma and dry eye disease are often present in the same patient, and eye care providers often want to address both as part of the patient’s treatment plan. We are already seeing this overlap, where we are driving new TearCare adopters from our existing glaucoma customer base. As we continue to drive earlier, procedure-based care across these two significant market opportunities, OMNI and TearCare can fit naturally along the same patient journey, supporting consistent clinical outcomes for patients as well as practice efficiency for providers. Over time, that broader portfolio participation can assist deepen account penetration and support our efforts to scale both of these businesses and drive sustainable growth long term.

Our strategy is to assist advance interventional care earlier in the treatment paradigm of both glaucoma and dry eye disease, and to accelerate these efforts by leveraging the overlap of our two interventional business segments that we call the intersection of intervention. We launched to drive momentum from this unique intersection in the first quarter. As we build on this progress, we remain focutilized on delivering sustainable growth and creating long-term value for our stakeholders. Now turning to our segments, I will launch with Interventional Dry Eye. In our first full quarter following initial market access, we drove expanded traction in our reimbursed dry eye business and increased customer adoption of our TearCare technology.

We are increasing our Interventional Dry Eye revenue guidance by $1 million at the midpoint based on our strong results ahead of expectations and our confidence relocating forward. We are very pleased by the commercial traction we generated with our dry eye customers in the first quarter, where we delivered revenue of $1.4 million, nearly doubling our fourth quarter revenue. The majority of this revenue was from our disposable SmartLids, and we sold approximately 1,500 in the first quarter, up from approximately 700 in 2025, more than doubling the volume. This includes sales to 96 accounts, created up of a balanced mix of new accounts and reordering accounts.

Average SmartLids utilization increased from 9 per active account in the fourth quarter to approximately 16 per active account in the first quarter. Our strong dry eye performance is primarily in the First Coast and Novitas regions, where fee schedules were recently established. We are pleased with the early validation of our reimbursed business model and solid customer engagement with TearCare. In addition, we are driving encouraging cross-selling dynamics, with approximately half of all active accounts coming from our existing glaucoma customer base and with higher utilization in those accounts versus the Interventional Dry Eye-only customers. These early indicators demonstrate the depth and value of our established relationships, and the synergies that exist between our two business segments.

Importantly, early utilization trfinishs are improving, with a growing number of accounts reordering and increasing procedure volumes. For accounts that reordered in the first quarter, utilization more than doubled from fourth quarter volumes. In addition, new accounts onboarded in the first quarter are ramping at higher initial levels than those in the prior quarter. Toreceiveher, these dynamics point to improved customer tarreceiveing and enhanced office workflow training, strengthening adoption and early momentum for scaling this business. We are also focutilized on supporting practices as they incorporate TearCare into their workflow. A growing number of accounts have successfully completed reimbursed procedures and reordered SmartLids, which we view as a positive early indicator of repeat utilization.

This adoption reflects the effectiveness of our tarreceiveed commercial approach, prioritizing high-volume dry eye practices with significant Medicare patient volumes. These efforts are translating into meaningful traction, with increasing interest from both new and existing accounts, supporting the broader shift towards interventional dry eye care. To build on this foundation, we have continued to expand our commercial team in the first quarter, adding resources in both our sales rep and clinic support functions, to enhance execution and deepen provider engagement. Our focus remains on scaling efficiently within established reimbursed markets while positioning the organization to drive meaningful growth as we shift through 2026.

In parallel, we are also focutilized on expanding market access through engagement with additional MACs as well as commercial payers. We are actively engaged in discussions with multiple MACs, including detailed reviews of our clinical and economic data, and submitted TearCare claims reviews. Based on these activities and discussions, we expect additional payers to establish fee schedules this year. We are encouraged by our continued progress and view expanding TearCare market access as an important catalyst to support long-term growth. Building on a foundation of clinically differentiated technology, initial reimbursement in select markets, ongoing reimbursement discussions, and strong commercial traction, we are excited about our opportunity to drive the development of this large and underpenetrated reimbursed interventional dry eye market.

Turning to Interventional Glaucoma. Our OMNI technology continues to demonstrate its clinical value within the evolving glaucoma treatment paradigm and its increasing importance as a differentiated technology and durable growth driver in the expanding field of interventional glaucoma. In the first quarter, we delivered strong performance and generated the third consecutive quarter of year-over-year growth. Revenue was $18.3 million, up 7% versus the prior year period. Ordering accounts increased 6% compared to the prior year period, driven primarily by reactivating dormant accounts and adding new accounts. The revenue growth was primarily driven by increased volume and price, partially offset by slightly lower utilization per account.

We finished the first quarter with a strong March, with procedure volumes increasing from a slower than typical start in January and February. Additionally, we drove continued strong adoption of OMNI Edge, which assisted in reactivating accounts and adding new accounts. OMNI Edge includes a higher-capacity viscoelastic delivery feature, while maintaining the trusted safety, efficacy, and usability of the OMNI technology platform. For 2026, our Interventional Glaucoma strategy is anchored in consistent execution, as we work to expand the combo cataract market and capture additional share as well as further unlock the stand-alone market opportunity.

In the combo cataract market, we are focutilized on adding accounts through training new surgeons, capturing share in existing accounts, expanding adoption and penetration with MIGS-naive surgeons, and increasing combo cataract volumes through interventional glaucoma activations. In stand-alone, we have hired a dedicated market development team and are encouraged by the early progress they are building in activating stand-alone glaucoma interventions. Toreceiveher with our differentiated technology and experienced commercial organization, we are in a strong position to deliver our growth tarreceives in 2026 in Interventional Glaucoma.

Looking closer at the stand-alone opportunity, as the shift toward earlier interventional treatment continues to shape the glaucoma treatment landscape, our effective market development team has been instrumental in partnering with surgeons and their staff to assist them introduce a streamlined and actionable interventional glaucoma patient workflow that is modeled after the well-known and proven cataract patient workflow. This differentiated approach is assisting practices identify patients and support increased procedural interventions in those practices adopting this workflow. We believe this new interventional glaucoma patient workflow partnership with our customers represents an important driver of market development and a growing contributor to long-term revenue growth.

Before turning the call over to Jim, I want to briefly touch on the latest regarding our patent infringement case against Alcon. In April, the court issued its final judgment, which upheld the jury’s finding of willful infringement by Alcon, and confirmed past damages and interest totaling approximately $55 million, as well as ongoing royalties of 10% of Hydrus revenue through patent expiration. This ruling is subject to appeal, and no cash has been received to date.

To close, we delivered a strong start to 2026 in both our Interventional Glaucoma and Interventional Dry Eye business segments, and the progress we created in the first quarter reinforces our confidence in the year ahead, including our decision to raise revenue guidance while maintaining our adjusted operating expense guidance. In Interventional Glaucoma, we generated our third consecutive quarter of year-over-year growth and remain focutilized on expanding our leadership position in the combo cataract segment while continuing to activate stand-alone intervention. In Interventional Dry Eye, we are encouraged by increasing customer adoption and utilization, and we remain focutilized on scaling efficiently in markets where reimbursement is in place while working to expand market access over time.

We are also excited about the increased recognition within the eye care community that there is strong patient overlap between Interventional Glaucoma and Interventional Dry Eye. We are uniquely positioned to leverage this synergy with two leading interventions for these two large and overlapping disease categories as we build something largeger—a leading interventional eye care company. Across the company, we are investing to support growth while maintaining the operating and financial discipline requireded to improve cash usage and advance our path toward cash flow breakeven. With that, I will turn the call over to Jim to walk through the financials.

Jim Rodberg: Thanks, Paul. Before discussing the first quarter results, I want to underscore that we are executing against our strategic goals from a position of strength, with the operating discipline and cost structure we required to support growth, and we believe this positions us to achieve cash flow breakeven without the required to raise additional equity capital. Unless otherwise noted, my comments reflect results for 2026 and comparisons to the same period in the prior year. In the first quarter, total revenue was $19.7 million, a 13% increase driven by growth in each of our two interventional segments.

Interventional Glaucoma revenue was $18.3 million, an increase of 7%, driven by increases in ordering accounts and average selling prices, partially offset by lower utilization per account. Ordering accounts grew 6% from the prior year as well as 1% sequentially from the fourth quarter. Interventional Dry Eye revenue was $1.4 million, up from $400,000 and nearly doubling from 2025. Dry eye results were driven by increases in average selling prices, utilization, and ordering accounts, reflecting strong momentum in our reimbursed Interventional Dry Eye business model. Gross margin was 86%, flat compared to the prior year.

Interventional Glaucoma gross margin remained strong at 87%, in line with the prior year period on higher average selling prices and product mix, slightly offset by tariff costs. Interventional Dry Eye gross margin was 72%, up from 71% in the same period in the prior year, primarily due to higher average selling prices and increased SmartLids sold, mostly offset by a one-time inventory overhead adjustment in the prior year. Over time, we expect our dry eye margins to continue to improve as we scale our reimbursed business model and offset absorption and overhead costs.

Total operating expenses were $29.4 million, an increase of 2% compared to $29 million, primarily due to a $5.4 million one-time fee earned upon a successful final judgment in the Alcon litigation case described above. Excluding this fee, operating expenses were down 17%, driven primarily by lower personnel-related expenses and stock-based compensation. As a reminder, we conducted a reduction in force in 2025, and this past quarter was the second full quarter of our lower cost structure. Adjusted operating expenses were $21.2 million, down 14% compared to $24.7 million. Net loss was $13 million, or $0.24 per share, compared to a net loss of $14.2 million, or $0.28 per share.

We finished the quarter with $85 million of cash and cash equivalents, compared to $92 million at year-finish 2025. Cash utilized was $7 million in the quarter, which was down significantly from $11.6 million in 2025. We finished the quarter with $40 million of debt, excluding unamortized discount and debt issuance costs. Moving to our revenue outview for full year 2026, we are raising revenue guidance to $83 million to $89 million, which reflects growth of 7% to 15% compared to 2025, versus the prior guidance of $82 million to $88 million.

This includes revenue for our Interventional Glaucoma segment of $77 million to $81 million, representing growth of 2% to 7%, and our Interventional Dry Eye segment of $6 million to $8 million, compared to $1.6 million in the prior year. This guidance reflects our philosophy of setting achievable tarreceives and our focus on disciplined execution and the growth we believe we can deliver. Looking closer at the second quarter, we expect total revenue to grow low double digits compared to 2025. We expect Interventional Glaucoma to grow mid-single digits compared to 2025.

Interventional Dry Eye revenue is expected to be in the range of $1.5 million to $2 million in the second quarter, and we expect that revenue to continue to scale throughout the year. We are reaffirming our full year 2026 adjusted operating expense guidance of $93 million to $96 million, representing an increase of 6% to 9% compared to 2025. The increased spfinish compared to the prior year is driven by tarreceiveed commercial investments to capture growth opportunities in both Interventional Dry Eye and Interventional Glaucoma, while we continue to manage the business with operating discipline. We are pleased with our return to double-digit revenue growth in the first quarter.

Looking ahead, we are excited to continue pioneering the Interventional Glaucoma and Interventional Dry Eye markets, and we are laying a strong foundation for sustainable growth and continued success. Operator, please open the line for questions.

Operator: Thank you. At this time, we will conduct the question-and-answer session. As a reminder, to question a question, you will required to press 11 on your telephone and wait for your name to be announced. To withdraw your question, please press 11 again. Please standby while we compile the Q&A roster. Our first question comes from the line of Frank Takkinen of Lake Street Capital Markets. Your line is now open.

Analyst: Hey. This is Nelson on for Frank. Thanks for all the color, and congrats on the solid progress. Maybe just to start, I want to start on the SmartLids utilization stepping from 9 to 16 in the quarter per active account, which was a strong read there. For your most mature, fully reimbursed accounts, can you talk about that steady-state utilization and how we should consider about that trajectory for the broader installed base relocating forward?

Alison Bauerlein: Yes, thanks, Nelson. It is a great question. The good news is I do not consider we are anywhere close to a steady state yet. All of our accounts are still relatively early in their usage of TearCare across their traditional Medicare fee-for-service population, and I consider even our largest accounts are not yet fully activating this across their patient population. Once we also receive additional coverage, that will allow our customers to treat more and more patients across their patient pool. I will declare, when we view at our customer mix, there are a handful of accounts—probably 10% of the accounts—that are driving a larger portion of the total volume here.

Those are accounts that have really figured out the workflow, how to put this into their overall practice, and frankly we are really proud of the progress we had in the first quarter, almost 100 active accounts. These accounts are truly the early adopters of TearCare, the true believers in the future of procedural dry eye intervention, and we really see all of our customers as still very early in their utilization curves, which is a testament to how large this market is and how many patients could benefit from a procedural dry eye intervention.

Analyst: Got it. That is very assistful. And then just quickly, you called out adding sales reps and clinical support resources during the quarter. Can you maybe size the Interventional Dry Eye team today and where we should see that going throughout the year?

Alison Bauerlein: We are not going to provide a detailed sales force headcount every quarter, but we did incrementally add in the quarter. We reported at year-finish 2025 that we had about 10 between our direct sales force as well as clinical specialists. So that team is still very tiny and growing. We are investing in the team, really focutilized on those First Coast and Novitas areas where we have Medicare fee schedules established, and we would expect to continue to grow that team throughout the year.

Analyst: Understand. Thank you, and congrats.

Operator: Thank you. Our next question comes from the line of Adam Maeder of Piper Sandler. Your line is now open.

Adam Maeder: Congrats on a good start to the year. Two for me. First, I wanted to start on Interventional Glaucoma and really was hoping you could double-click and contextualize the good result there, the plus 7% year over year. Curious to receive your view on underlying market trfinishs, competitive dynamics—I consider one competitor may have had a bit of a supply issue—pricing, and then you talked about some inclement weather. Did you recapture those patients in the quarter? Just bring that all toreceiveher for us, and then I have a follow-up.

Paul Badawi: Hi, Adam. We are excited to be back in growth mode in Interventional Glaucoma. The glaucoma community recognizes now that intervening earlier is better long term for patients, so there is a real tailwind in the ophthalmic community—you can feel it. We were just at ASCRS last month, and there is so much talk around earlier intervention, both IG—Interventional Glaucoma—as well as IDE—Interventional Dry Eye. On the glaucoma side, there are millions of glaucoma patients currently on medications who could benefit from an earlier intervention. That market is growing. We are excited to be a leader.

We are the leading implant-free microinvasive glaucoma surgical option in the market, and over time, as this category grows, we expect to continue to innovate and lead the category we have created. We have new technology coming out; we are attempting to stay ahead of the market with OMNI Ultra later this year. It is our third straight quarter of year-over-year growth, so we are excited about that tailwind and continuing to lead as the implant-free market leader in IG.

Jim Rodberg: Adam, this is Jim. On the Q1 dynamics, we closed the quarter very strongly. March tfinishs to be a significant part of the first quarter, and the team executed really well. We leave the first quarter feeling really good about where we are at. We had strength in March, and we expect that strength and momentum to continue into Q2 and the balance of the year. Overall, we are confident about our path forward.

Adam Maeder: Fantastic. Very assistful color, and great to hear comments on the market. Switching over to dry eye—congratulations, Ali, on the progress there. I wanted to push a little in terms of market access and better understand expectations for new payer adds, whether on the commercial or MAC side. Can you be more specific on potential timing? And can you hit the updated $6 million to $8 million without any additional payer wins? Thank you.

Alison Bauerlein: Thanks for the follow-up. We are very focutilized on increasing reimbursed access to TearCare with both Medicare and commercial payers. We are having continued good conversations across the payer mix, really focutilized on the SAHARA data, the health economic data, and also revealing claims utilization and interest in the procedure. We are building a category here, and that does take time. We still expect to have additional payer wins in 2026; it is hard to predict exact timing. We fundamentally do not feel any different about our ability to receive payer wins over time and to receive access to this technology for our patients and our ECP provider partners.

We do have some incremental positive shiftment with commercial payers—there are some paying regularly while they have not established coverage policies, and others are relocating towards those activities. In terms of guidance, yes, we feel extremely confident. The guidance only takes into account First Coast and Novitas fee schedules in place for 2026. That market potential alone is very large for us. We are still a very tiny fraction of the patients with moderate to severe dry eye disease with MGD, even within that traditional Medicare fee-for-service population. We are in very early stages in a large market, and we set guidance appropriately for the areas where we currently have fee schedules established.

Operator: Thank you. Our next question comes from the line of Steven Lichtman of William Blair. Your line is now open.

Steven Lichtman: Congratulations on the progress. Wondering if you could talk about customer accounts for dry eye in the regions where you are approved with reimbursement. What is your latest view on the denominator—the number of viable centers that you consider are tarreceive sets for you within the regions you are currently in?

Alison Bauerlein: I will shift that question a bit and talk about ECPs—eye care providers—becautilize that is an clearer way of considering about the opportunity. Across the U.S., when we tarreceive providers that do a lot of prescription eye drops, perform procedural interventions for dry eye, and have strong patient populations, we have historically talked about roughly 6,500 ECPs as that initial tarreceive population. Within First Coast and Novitas, there are about 2,000 ECPs that meet that same criteria. We are still very tiny. Obviously, active accounts is different from ECP counts, and even with there being a couple of ECPs per active account, we are very much in the early penetration days within First Coast and Novitas.

Steven Lichtman: Great. And then just a follow-up on the patent suit. Obviously a decent amount of cash pfinishing here for you. Can you talk about the next steps? I consider Alcon has an opportunity to appeal within the next couple of weeks, or there could be a settlement. What are the next steps? And remind us of the interest accrual if it does go to appeal?

Jim Rodberg: In April, final judgment was issued and that preserved the jury verdict from 2024 that awarded us updated damages, interest, and royalty of approximately $55 million, as well as ongoing royalties of 10% of future Hydrus sales through the patent expiration. We have not received any cash to date, and we will not book anything until such time as appeals are exhausted and cash modifys hands, for example. The final judgment is subject to appeal. Beyond that, we will not comment further on pfinishing litigation, but we feel we are in a very strong position in this case.

Steven Lichtman: Okay. Great. Thanks.

Operator: Our next question comes from the line of Thomas M. Stephan of Stifel. Your line is now open.

Thomas M. Stephan: Thanks for taking the questions. First on dry eye—nice to see the guidance raise and already really strong sequential growth in utilization. Big picture, what have been the top one or two upside surprises or learnings amidst this relaunch? And part two, how do you feel about the playbook you are developing for when different markets and patient populations hopefully unlock, and your ability to deploy that quickly?

Alison Bauerlein: We have had a lot of learnings since launch, most of them very positive—both about how large this opportunity is and how many patients are viewing for a better treatment—and also the synergies with our Interventional Glaucoma business. That is probably the largest benefit we have seen. Those accounts are a large part of the accounts that have activated in these early stages. They have larger traditional Medicare fee-for-service populations, and they are viewing for ways to assist their patients who also experience significant dry eye. That is a large part of our initial launch, and we also see those accounts having higher utilization than non-IG-synergistic accounts—really positive momentum and good synergies across the team.

In terms of the playbook as we shift forward, there is still a lot of workflow activation that requireds to occur when an account decides to implement procedural dry eye. We consider this involves people being in accounts and assisting clinics set up their workflow, identify the patients, and determine how best to put them into a dry eye treatment workflow. As we have additional market access wins, particularly in new geographies, that will involve additional commercial investments as we grow the team and work with accounts we already have in those areas.

As we receive additional density with more payers coming on in markets where we already have Medicare fee schedules, those are clearer to activate becautilize it is adding new payers into the same workflow. Over time, that may also shift the accounts we tarreceive. Right now, we are tarreceiveing many higher-volume ophthalmology practices with a lot of Medicare patients, which is where we are seeing synergies with IG. Over time, as commercial plans come on—about 70% of dry eye disease patients are covered by commercial and 30% by Medicare/Medicare Advantage—that can shift our account tarreceiveing and partnerships.

We are happy with the progress in creating a workflow within accounts, and it is being replicated efficiently so they can work TearCare into their procedure flow—whether that is a dedicated TearCare day or multiple TearCare sessions across mornings or afternoons. They tfinish to stack them to be efficient. We are doing assessments up front to identify patients who may benefit from a procedural dry eye intervention and working that into the workflow. A lot is coming toreceiveher, and we are in a good spot to continue executing across this new area.

Paul Badawi: I want to add a few considereds to Alison’s comments around the intersection. Sight Sciences, Inc. started interventional—we started with OMNI and then developed TearCare. These are two very strong interventions for two of the leading diseases in eye care. While that has been our philosophy, I consider what we have seen—and been pleasantly surprised by—is the rate at which our customers, specifically surgeons, have recognized the overlap of these two disease categories and the possibilities of offering these same patients multiple interventions. The alignment between the ophthalmic community and our philosophy of building an interventional eye care company has come rapider than we expected.

When we meet with our happy OMNI surgeons and work with our dedicated commercial team, it is amazing how many of our glaucoma surgeons talk about how many of their glaucoma patients have dry eye disease and are complaining about their dry eye disease—glaucoma is unfortunately a silent disease. Being able to reveal up as their interventional partner with an intervention for their glaucoma patient and an intervention for the same patient who also has dry eye disease is a very powerful partnership. We are happy with how rapid the community is acknowledging that. Internally we call it IX—the intersection of intervention.

It is a proprietary angle we have, and we view forward to driving the benefits and synergies of these interventional platforms to reach more patients with better interventions, offering better care more quickly.

Operator: Our next question comes from the line of Joanne Karen Wuensch of Citi.

Joanne Karen Wuensch: Good afternoon, and thanks for taking the question. You seem to be building a fair amount of progress on expense management, cash management, and everything else that goes along with it. Can you give us a view on your philosophy of how you balance penetrating the MACs, educating physicians, and ramping them with the other metrics we on the Street watch?

Jim Rodberg: Hey, Joanne. Thanks for the question. We are in a really good spot with a healthy balance sheet and a strong path to cash flow breakeven, while at the same time having the ability to invest in these two significant opportunities. As we view at 2026, the most important investments this year are on the dry eye side—both in market access resources and commercial resources to scale up that business in markets where we already have reimbursement—and on the glaucoma side, continuing to invest in the stand-alone opportunity. The balance for us is to create disciplined, high-return investments. We are fortunate to have the flexibility to go rapider on some of those investments where there is outsized opportunity for growth.

Paul Badawi: The only thing I would add on R&D: we have a history of cost-effectively developing clinically differentiated interventions that can elevate the standard of care. We have done that well with OMNI and TearCare. We are building very selective R&D investments—all within this interventional category—as we build a focutilized interventional eye care company. We have a very interesting pipeline that we are developing cost effectively, and in due course we view forward to sharing more, hopefully later this year.

Joanne Karen Wuensch: Wonderful. Thank you.

Operator: Thank you. Our next question comes from the line of David Saxon of Needham & Company. Your line is now open.

David Saxon: Good afternoon, Paul, Ali, and Jim. Thanks for taking my questions. A similar question to Adam’s but from a slightly different angle. I consider you are only in four of the 13 states in First Coast and Novitas. Does the guide assume you receive into any more of those states, or is the $6 million to $8 million really just reflective of presence in a fraction of the immediate opportunity?

Alison Bauerlein: We have sales across most of the states, and we do have some level of sales support across them, but you are right—we have density within four to five main states that have the majority of the sales resources. We expect to continue to expand resources. Whether we expand within those specific four to five states—there is still opportunity. For example, one rep in Florida would not be sufficient to cover the entire state. We are viewing at where we invest those resources. The plan takes into account incremental investments in commercial resources in those areas. We are not going to receive into specific territories, but all of that is accounted for in our operating expense guidance.

David Saxon: Thanks for that. On the IG side, Paul or Ali, would love an update on the Ultra timing of clearance. Is that embedded in the IG revenue guidance, or would that be upside when that comes out?

Paul Badawi: We are in discussions with the FDA on OMNI Ultra. While nothing is definitive with 510(k) clearance pathways, we feel confident that we should have a clearance within the coming months—certainly by the finish of the year. We are very excited to launch Ultra, hopefully by the finish of the year. It has a number of surgeon-informed features: single incision, single pass 360°, viscoelastic delivery on both advancement and retraction, catheter markings to indicate advancement, and improved handle ergonomics. We consider these features will assist elevate the category further. We have put out guidance that we are very confident we can deliver regardless of when Ultra arrives. Hopefully it arrives sooner rather than later, and we can do even better.

Operator: Thank you. This concludes the question-and-answer session. I would now like to turn it back to Paul Badawi for closing remarks.

Paul Badawi: Thank you all for attfinishing today’s call. We appreciate your interest in Sight Sciences, Inc., and we view forward to updating you on our progress in the future.

Operator: Thank you for your participation in today’s conference. This concludes the program. You may now disconnect.

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