Q1 2026 Sight Sciences Inc Earnings Call

May 6, 2026

Speaker #1: Good day, and thank you for standing by. Welcome to the Sight Sciences, first quarter, 2026 earnings results conference call. At this time, all participants are in a listen-only mode.

Operator: Good day, and thank you for standing by. Welcome to the Sight Sciences, Inc. Q1 2026 Earnings Results Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 11 on your telephone. You will hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Hannah Jefferies, Investor Relations. Please go ahead.

Operator: Good day, and thank you for standing by. Welcome to the Sight Sciences Q1 2026 earnings results conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 11 on your telephone. You will hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Hannah Jefferies, Investor Relations. Please go ahead.

Speaker #1: After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star 11 on your telephone.

Speaker #1: You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded.

Speaker #1: I would now like to hand the conference over to your first speaker today, Hannah Jeffrey, Investor Relations. Please go ahead.

Speaker #2: Thank you for participating in today's call. Presenting today are Sight Sciences co-founder and chief executive officer, Paul Badawi, and chief financial officer, Jim Rodberg.

Hannah Jefferies: Thank you for participating in today's call. Presenting today are Sight Sciences Co-founder and Chief Executive Officer, Paul Badawi, and Chief Financial Officer, Jim Rodberg. Also in attendance is Sight Sciences Chief Operating Officer, Alison Bauerlein. Earlier today, Sight Sciences released financial results for Q1 ended 31 March 2026 and raised its revenue guidance and maintained 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 made by management today and answers to questions will include forward-looking statements, including statements about material business considerations, 2026 outlook, and financial guidance. These statements are based on plans and expectations as of today, which may change over time.

[Company Representative] (Sight Sciences): Thank you for participating in today's call. Presenting today are Sight Sciences Co-founder and Chief Executive Officer, Paul Badawi, and Chief Financial Officer, Jim Rodberg. Also in attendance is Sight Sciences Chief Operating Officer, Alison Bauerlein. Earlier today, Sight Sciences released financial results for Q1 ended 31 March 2026 and raised its revenue guidance and maintained 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 made by management today and answers to questions will include forward-looking statements, including statements about material business considerations, 2026 outlook, and financial guidance. These statements are based on plans and expectations as of today, which may change over time.

Speaker #2: Also in attendance is Sight Sciences chief operating officer, Allie Bauerlein. Earlier today, Sight Sciences released financial results for the first quarter ended March 31, 2026.

Speaker #2: And raised its revenue guidance and maintained its adjusted operating expense guidance for full year 2026. A copy of the press release is available on our website at investors.sightciences.com.

Speaker #2: I would like to remind everyone that comments made by management today and answers to questions will include forward-looking statements. Including statements about material business considerations, 2026 outlook, and financial guidance.

Speaker #2: These statements are based on plans and expectations as of today, which may change over time. In addition, actual results could differ materially from projected results due to a number of risks and uncertainties.

Hannah Jefferies: 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-looking 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 because they exclude items that are unrelated to and may not be indicative of its core operating results.

[Company Representative] (Sight Sciences): 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-looking 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 because they exclude items that are unrelated to and may not be indicative of its core operating results.

Speaker #2: 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.

Speaker #2: We undertake no obligation to publicly update or revise any forward-looking 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.

Speaker #2: Including adjusted operating expenses. We believe these non-GAAP financial measures are important indicators of the company's operating performance because they exclude items that are unrelated to, and may not be indicative of, its core operating results.

Speaker #2: See our earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP financial measures. As well as additional information about our reliance on non-GAAP financial measures.

Hannah Jefferies: See our earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP financial measures, as well as additional information about our reliance on non-GAAP financial measures. I'll now turn the call over to Paul.

[Company Representative] (Sight Sciences): See our earnings release for a reconciliation of these non-GAAP financial measures to the most directly comparable GAAP financial measures, as well as additional information about our reliance on non-GAAP financial measures. I'll now turn the call over to Paul.

Speaker #2: And I'll turn the call over to Paul.

Speaker #1: 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.

Paul Badawi: Thanks, Hannah. Good afternoon, and thank you for joining us. We delivered a strong start to 2026, with Q1 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 a Q3 in a row of revenue growth in Interventional Glaucoma and continued positive commercial traction in Interventional Dry Eye, where revenue nearly doubled from Q4, representing early validation of our procedural in-office recurring revenue business model. Based on our performance and outlook, we are raising our full year 2026 revenue guidance while maintaining our adjusted operating expense guidance.

Speaker #1: 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.

Speaker #1: This included a 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.

Speaker #1: Based on our performance and outlook, 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 focused 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.

Paul Badawi: We are continuing to build an interventional eye care company focused 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 causes of disease and can efficiently integrate into established practice workflows. They each support our focus on earlier procedure-based care while helping 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 mixed 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. Eye care providers often want to address both as part of the patient's treatment plan.

Speaker #1: Our two flagship technologies, Omni and TearCare, are designed to address the root underlying causes of disease and can efficiently integrate into established practice workflows.

Speaker #1: They each support our focus on earlier procedure-based care while helping 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.

Speaker #1: 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.

Speaker #1: We're 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.

Paul Badawi: We're 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 help deepen account penetration and support our efforts to scale both of these businesses and drive sustainable growth long term. Our strategy is to help 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 began to drive momentum from this unique intersection in Q1.

Speaker #1: Supporting consistent clinical outcomes for patients as well as practice efficiency for providers. Over time, that broader portfolio participation can help deepen account penetration and support our efforts to scale both of these businesses and drive sustainable growth long-term.

Speaker #1: Our strategy is to help 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.

Speaker #1: We began to drive momentum from this unique intersection in the first quarter. As we build on this progress, we remain focused on delivering sustainable growth and creating long-term value for our stakeholders.

Paul Badawi: As we build on this progress, we remain focused on delivering sustainable growth and creating long-term value for our stakeholders. Now, turning to our segments, I'll begin 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 moving forward. We are very pleased by the commercial traction we generated with our dry eye customers in Q1, where we delivered revenue of $1.4 million, nearly doubling our Q4 revenue.

Speaker #1: Now, turning to our segments, I'll begin 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.

Speaker #1: We are increasing our interventional dry eye revenue guidance by 1 million dollars at the midpoint based on our strong results ahead of expectations and our confidence moving forward.

Speaker #1: 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.

Speaker #1: The majority of this revenue was from our disposable smart lids, and we sold approximately 1,500 in the first quarter, up from approximately 700 in the fourth quarter of 2025.

Paul Badawi: The majority of this revenue was from our disposable SmartLids, and we sold approximately 1,500 in Q1, up from approximately 700 in Q4 2025, more than doubling the volume. This includes sales to 96 accounts made up of a balanced mix of new accounts and reordering accounts. Average SmartLids utilization increased from approximately 9 per active account in Q4 to approximately 16 per active account in Q1. 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.

Speaker #1: More than doubling the volume. This includes sales to 96 accounts, made up of a balanced mix of new accounts and reordering accounts. Average SmartLids utilization increased from approximately 9 per active account in the fourth quarter to approximately 16 per active account in the first quarter.

Speaker #1: 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.

Speaker #1: 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.

Paul Badawi: 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 trends are improving, with a growing number of accounts reordering and increasing procedure volumes. For accounts that reordered in Q1, utilization more than doubled from Q4 volumes. New accounts onboarded in Q1 are ramping at higher initial levels than those in the prior quarter. Together, these dynamics point to improved customer targeting and enhanced office workflow training, strengthening adoption and early momentum for scaling this business. We are also focused on supporting practices as they incorporate TearCare into their workflow.

Speaker #1: 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 trends are improving.

Speaker #1: 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.

Speaker #1: In addition, new accounts onboarded in the first quarter are ramping at higher initial levels than those in the prior quarter. Together, these dynamics point to improved customer targeting and enhanced office workflow training strengthening adoption and early momentum for scaling this business.

Speaker #1: We are also focused 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.

Paul Badawi: 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 targeted 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 Q1, 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 move through 2026. In parallel, we are also focused on expanding market access through engagement with additional MACs as well as commercial payers.

Speaker #1: This adoption reflects the effectiveness of our targeted 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.

Speaker #1: 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.

Speaker #1: Our focus remains on scaling efficiently with an established reimbursed markets while positioning the organization to drive meaningful growth as we move through 2026. In parallel, we are also focused on expanding market access through engagement with additional MACs as well as commercial payers.

Speaker #1: 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.

Paul Badawi: 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 under-penetrated 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.

Speaker #1: 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 under-penetrated reimbursed interventional dry eye market.

Speaker #1: 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.

Speaker #1: 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.

Paul Badawi: In Q1, we delivered strong performance and generated the 3rd 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 and partially offset by slightly lower utilization per account. We finished Q1 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 helped 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.

Speaker #1: Ordering accounts increased 6% compared to the primarily by reactivating dormant accounts and adding new accounts. The revenue growth was primarily driven by increased volume and price and partially offset by slightly lower utilization per account.

Speaker #1: 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 helped in reactivating accounts and adding new accounts.

Speaker #1: 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 standalone market opportunity.

Paul Badawi: 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 standalone market opportunity. In the combo cataract market, we are focused 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 standalone, we have hired a dedicated market development team and are encouraged by the early progress they are making in activating standalone glaucoma interventions. Together with our differentiated technology and experienced commercial organization, we are in a strong position to deliver our growth targets in 2026 in interventional glaucoma.

Speaker #1: In the combo cataract market, we are focused 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.

Speaker #1: In standalone, we have hired a dedicated market development team and are encouraged by the early progress they are making in activating standalone glaucoma interventions.

Speaker #1: Together with our differentiated technology and experienced commercial organization, we are in a strong position to deliver our growth targets in 2026 in interventional glaucoma.

Speaker #1: Looking closer at the standalone 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 help them introduce a streamlined and actionable interventional glaucoma patient workflow that is modeled after the well-known and proven cataract patient workflow.

Paul Badawi: Looking closer at the standalone 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 help 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 helping 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.

Speaker #1: This differentiated approach is helping 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.

Speaker #1: 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 hydrous revenue through patent expiration.

Paul Badawi: 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 made in the Q1 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 focused on expanding our leadership position in the combo cataract segment while continuing to activate standalone intervention.

Speaker #1: 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 made in the first quarter reinforces our confidence in the year ahead.

Speaker #1: 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 remained focused on expanding our leadership position in the combo cataract segment while continuing to activate standalone intervention.

Speaker #1: In interventional dry eye, we are encouraged by increasing customer adoption and utilization, and we remain focused on scaling efficiently in markets where reimbursement is in place, while working to expand market access over time.

Paul Badawi: In interventional dry eye, we are encouraged by increasing customer adoption and utilization. We remain focused on scaling efficiently in markets where reimbursement is in place while working to expand market access over time. We are also excited about the increasing 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 bigger, a leading interventional eye care company. Across the company, we are investing to support growth while maintaining the operating and financial discipline needed to improve cash usage and advance our path toward cash flow breakeven. With that, I'll turn the call over to Jim to walk through the financials.

Speaker #1: We are also excited about the increasing recognition within the eye care community that there is strong patient overlap between interventional glaucoma and interventional dry eye.

Speaker #1: We are uniquely positioned to leverage this synergy with two leading interventions for these two large and overlapping disease categories as we build something bigger.

Speaker #1: A leading interventional eye care company. Across the company, we are investing to support growth while maintaining the operating and financial discipline needed to improve cash usage and advance our path toward cash flow breakeven.

Speaker #1: With that, I'll turn the call over to Jim to walk through the financials.

Speaker #2: 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.

Jim Rodberg: Thanks, Paul. Before discussing the Q1 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 need to support growth, and we believe this positions us to achieve cash flow breakeven without the need to raise additional equity capital. Unless otherwise noted, my comments reflect results for Q1 2026, and comparisons are to the same period in the prior year. In Q1, 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, and partially offset by lower utilization per account.

Speaker #2: With the operating discipline and cost structure we need to support growth, and we believe this positions us to achieve cash flow breakeven without the need to raise additional equity capital.

Speaker #2: Unless otherwise noted, my comments reflect results for the first quarter of 2026 and comparisons are 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.

Speaker #2: Interventional glaucoma revenue was $18.3 million, an increase of 7%, driven by increases in ordering accounts and average selling prices, and partially offset by lower utilization per account.

Speaker #2: 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 0.4 million, and nearly doubling from the fourth quarter of 2025.

Jim Rodberg: Ordering accounts grew 6% from the prior year as well as 1% sequentially from the Q4. Interventional dry eye revenue was $1.4 million, up from $0.4 million and nearly doubling from the Q4 of 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 remains strong at 87%, in line with the prior year period on higher average selling prices and product mix, slightly offset by tariff costs.

Speaker #2: 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.

Speaker #2: 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.

Speaker #2: 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.

Jim Rodberg: 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.

Speaker #2: 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.

Speaker #2: 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.

Speaker #2: 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 the third quarter of 2025, and this past quarter was the second full quarter of our lower cost structure.

Jim Rodberg: As a reminder, we conducted a reduction in force in Q3 2025. 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 ended the quarter with $85 million of cash and cash equivalents, compared to $92 million at the end of 2025. Cash used was $7 million in the quarter, which was down significantly from $11.6 million in Q1 2025. We ended the quarter with $40 million of debt, excluding unamortized discount and debt issuance costs. Moving to our revenue outlook for full year 2026.

Speaker #2: 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.

Speaker #2: We ended the quarter with $85 million of cash and cash equivalents, compared to $92 million at the end of 2025. Cash used was $7 million in the quarter, which was down significantly from $11.6 million in the first quarter of 2025.

Speaker #2: We ended the quarter with $40 million of debt excluding unamortized ed discount and debt issuance costs moving to our revenue outlook for full year 2026.

Speaker #2: We are raising revenue guidance to $83 to $89 million, which reflects growth of 7 to 15 percent compared to 2025. Versus the prior guidance of $82 to $88 million.

Jim Rodberg: We are raising revenue guidance to $83 to 89 million, which reflects growth of 7% to 15% compared to 2025 versus the prior guidance of $82 to 88 million. This includes revenue for our Interventional Glaucoma segment of $77 to 81 million, representing growth of 2% to 7%, and our Interventional Dry Eye segment of $6 to 8 million, compared to $1.6 million in the prior year. This guidance reflects our philosophy of setting achievable targets and our focus on disciplined execution and the growth we believe we can deliver. Looking closer at Q2, we expect total revenue to grow low double digits compared to Q2 of 2025. We expect Interventional Glaucoma to grow mid-single digits compared to Q2 of 2025.

Speaker #2: This includes revenue for our interventional glaucoma segment of $77 to $81 million, representing growth of 2 to 7 percent, and our interventional dry eye segment of $6 to $8 million, compared to $1.6 million in the prior year.

Speaker #2: This guidance reflects our philosophy of setting achievable targets 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 the second quarter of 2025.

Speaker #2: We expect interventional glaucoma to grow mid-single digits compared to the second quarter of 2025. Interventional dry eye revenue is expected to be in the range of $1.5 to $2 million in the second quarter, and we expect that revenue to continue to scale throughout the year.

Jim Rodberg: Interventional dry eye revenue is expected to be in the range of $1.5 to 2 million in Q2. We expect that revenue to continue to scale throughout the year. We are reaffirming our full year 2026 adjusted operating expense guidance of $93 to 96 million, representing an increase of 6% to 9% compared to 2025. The increased spend compared to the prior year is driven by targeted commercial investments.

Speaker #2: We are reaffirming our full year 2026 adjusted operating expense guidance of $93 to $96 million, representing an increase of 6 to 9 percent compared to 2025.

Speaker #2: The increased spend compared to the prior year is driven by targeted commercial investments to capture growth opportunities in both interventional dry eye and interventional glaucoma, while we continue to manage the business with operating discipline.

Paul Badawi: 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 Q1. 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.

Jim Rodberg: 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 Q1. 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.

Speaker #2: 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.

Speaker #2: Operator, please open the line for questions.

Speaker #1: Thank you. At this time, we will conduct the question and answer session. As a reminder, to ask a question, you will need to press star 11 on your telephone and wait for your name to be announced.

Operator: Thank you. Our first question comes from the line of Frank Takkinen of Lake Street Capital Markets. Your line is now open.

Speaker #1: To withdraw your question, please press star 11 again. Please stand by while we compile the Q&A roster. Our first question comes from the line of Frank Takinen of Lake Street Capital Markets.

Speaker #1: Your line is now open.

Speaker #3: 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 smart lids utilization, stepping from 9 to 16 in the quarter per active account.

Nelson: Hey, this is Nelson on for Frank. Thanks for all the color and congrats on the solid progress. 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, kind of fully reimbursed accounts, can you talk about that steady state utilization and how we should think about that trajectory for the broader kind of installed base moving forward?

Nelson Cox: Hey, this is Nelson on for Frank. Thanks for all the color and congrats on the solid progress. 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, kind of fully reimbursed accounts, can you talk about that steady state utilization and how we should think about that trajectory for the broader kind of installed base moving forward?

Speaker #3: There was a strong read there. For your most mature, kind of fully reimbursed accounts, can you talk about that steady-state utilization and how we should think about that trajectory for the broader kind of installed base moving forward?

Speaker #4: Yeah, thanks, Nelson. And it's a great question and the good news is I don't think we're anywhere close to a steady state yet. All of our accounts are still relatively early in their usage of tear care across their Medicare traditional Medicare fee-for-service populations and so I think even our largest accounts are not yet fully activating this across their patient population.

Ali Bauerlein: Yeah. Thanks, Nelson, it's a great question. All of our accounts are still relatively early in their usage of TearCare across their Medicare, traditional Medicare fee-for-service population. I think even our largest accounts are not yet fully activating this across their patient population. Of course, once we can also get additional coverage, that will also allow our customers to treat more and more patients across their patient pool. I will say, you know, when we look at our customer mix, there are a handful of accounts, you know, probably 10% of the accounts that are driving a larger portion of the total volume here.

Speaker #4: And then, of course, once we can also get additional coverage, that will also allow our customers to treat more and more patients across their patient pool.

Speaker #4: I will say when we look at our customer mix, there are a handful of accounts probably 10 percent of the accounts that are driving a larger portion of the total volume here.

Speaker #4: And that's those are accounts that have really figured out the workflow, how to put this into their overall practice and frankly, we're really proud of the progress that we had in the first quarter.

Ali Bauerlein: Those are accounts that have really figured out the workflow, how to put this into their overall practice. Frankly, we're really proud of the progress that we had in Q1. Almost 100 active accounts. These accounts are really, like, the true early adopters of TearCare, the true believers in the future of procedural dry eye intervention. We really see all of our customers are still very early in their utilization curves, which is really just a testament to how large this market is and how many patients could benefit from a procedural dry eye intervention.

Speaker #4: Almost 100 active accounts these accounts are really like the true early adopters of tear care, the true believers and the future of procedural dry eye interventions.

Speaker #4: And we really see all of our customers are still very early in their utilization curves. Which is really just a testament to how large this market is and how many patients could benefit from a procedural dry eye intervention.

Speaker #3: Got it, that's very helpful. 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 just throughout the year?

Nelson: Got it. That's very helpful. 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 just throughout the year?

Nelson Cox: Got it. That's very helpful. 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 just throughout the year?

Speaker #4: Yeah. So we're not going to provide a detailed Salesforce headcount every quarter, but we did incrementally add in the quarter. I know we reported at the end of 2025 we had about 10 between our direct Salesforce as well as clinical specialists.

Ali Bauerlein: Yeah. We're not gonna provide a detailed sales force headcount every quarter, but we did incrementally add in the quarter. I know we reported at the end of 2025, we had about 10 between our direct sales force as well as clinical specialists. That team is still very small and growing. We are investing in the team, really focused 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.

Speaker #4: So that team is still very small and growing. So we are investing in the team really focused on those first coast and Novotel areas where we have Medicare fee schedules established and we would expect to continue to grow that team throughout the year.

Speaker #3: Understand. Thank you, guys, and congrats.

Nelson: Understand. Thank you guys, and congrats.

Nelson Cox: Understand. Thank you guys, and congrats.

Speaker #4: Thanks.

Ali Bauerlein: Thanks.

Speaker #1: Thank you. Our next question comes from the line of Adam Mater of Piper Sandler. Your line is now open.

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

Speaker #5: Hi, good afternoon. Thank you for taking the questions and congrats on a good start to the year. Two from me and I guess the first one, I wanted to start on interventional glaucoma.

Adam Maeder: Hi. Good afternoon. Thank you for taking the questions, congrats on a good start to the year. Two from me, I guess the first one, I wanted to start on interventional glaucoma. I really was hoping you could kind of double-click and contextualize, you know, the good result there, the +7% year-over-year. You know, curious to get your view on kind of underlying market trends, competitive dynamics. I think one competitor may have had a little bit of a supply issue, you know, pricing. You know, you obviously talked about some inclement weather. Did you recapture those patients in the quarter? Just maybe kind of bring that all together for us, I had a follow-up. Thanks.

Speaker #5: And I really was hoping you could kind of double-click and contextualize the good result there, the plus 7 percent year over year. Curious to get your view on kind of underlying market trends, competitive dynamics.

Speaker #5: I think one competitor may have had a little bit of a supply issue. Pricing and then you obviously talked about some inclement weather. So did you recapture those patients?

Speaker #5: In the quarter. So just maybe kind of bring that all together for us and then I have a follow-up. Thanks. Yeah. Hi, Adam. We're excited to be back in growth mode in IG and interventional glaucoma.

Paul Badawi: Yeah. Hi, Adam. We're excited to be back in growth mode in IG, in interventional glaucoma. The glaucoma community recognizes now that intervening earlier is better long term for patients. There's this real tailwind in the ophthalmic community. You can feel it. We were just at ASCRS, A-S-C-R-S, American Society of Cataract and Refractive Surgery meeting last month. There's just so much talk around earlier intervention, both IG, interventional glaucoma, as well as IDE, interventional dry eye. On the glaucoma side, we all know there's millions of glaucoma patients that are currently on medications and could benefit from an earlier intervention. That market is growing. We're excited to be a leader. We're the leading implant-free micro-invasive glaucoma surgical option in the market.

Speaker #5: The glaucoma community recognizes now that intervening earlier is better long-term for patients. So there's this real tailwind in the ophthalmic community. You can feel it.

Speaker #5: We were just at ASCRIS, ASCRS, American Society of Cataract and Refractive Surgery, meeting last month. And there's just so much talk around earlier intervention, both IG, interventional glaucoma.

Speaker #5: As well as IDE, interventional dry eye. On the glaucoma side, we all know there's millions of glaucoma patients that are currently on medications and could benefit from an earlier intervention.

Speaker #5: That market is growing. We're excited to be a leader. We're 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, lead the category we've created.

Paul Badawi: Over time, as this category grows, we expect to continue to innovate and lead the category we've created. We've got new technology coming out. We're trying to stay ahead of the market with OMNI Ultra later this year. It's our third straight quarter of year-over-year growth. We're excited about that. Excited about the tailwind of interventional glaucoma and continuing to lead as the, you know, implant-free, market leader in IG.

Speaker #5: We've got new technology coming out. We're trying to stay ahead of the market with Omni Ultra. Later this year, it's our third straight quarter of year-over-year growth.

Speaker #5: So we're excited about that. Excited about the tailwind of interventional glaucoma. And continuing to lead as the implant-free market leader in IG.

Speaker #1: And hey, Adam, this is Jim on the Q1 dynamics. We closed the quarter very strongly. As you can imagine, March tends to be a pretty significant part of the first quarter.

Jim Rodberg: Hey, Adam, this is Jim. On the Q1 dynamics, we closed the quarter very strongly. As you can imagine, March tends to be a pretty significant part of Q1, team executed really well. We leave Q1 feeling really, really good about where we're at. We had strength in March. We expect that strength and momentum to continue into Q2 and the balance of the year, overall, confident about our path forward.

Speaker #1: And team executed really well. And we leave the first quarter feeling really good about where we're at. We had strength in March. We expect that strength and momentum to continue into Q2 and the balance of the year.

Speaker #1: And overall, confident about our path forward.

Speaker #5: Okay. Fantastic. Very helpful color and great to hear the comments on the market. And then maybe switching over to dry eye, congratulations, Ellie, on the progress there.

Adam Maeder: Okay. Fantastic. Very helpful color and great to hear the comments on the market. Maybe switching over to dry eye, you know, congratulations, Ali, on the progress there. Wanted to push a little bit, you know, in terms of market access and try and better understand the expectations for new payer adds, you know, whether it's on the commercial or the MACs side. Not sure if you can be any more specific in terms of potential timing there. I guess really one of the questions I have is can you hit the updated six to eight million without any additional payer wins? Thank you for taking the questions.

Speaker #5: Wanted to push a little bit in terms of market access and try and better understand the expectations for new payer ads whether it's on the commercial or the Mac side.

Speaker #5: Not sure if you can be any more specific in terms of potential timing there. And I guess really the one of the questions I have is can you hit the updated six to eight million without any additional payer wins?

Speaker #5: And thank you for taking the questions.

Speaker #4: Yeah. Thanks for the follow-up here. And of course, we are also very focused on increasing reimbursed access to tear care with both Medicare payers as well as commercial payers.

Ali Bauerlein: Yeah. Thanks. Thanks for the follow-up here. Of course, we are also very focused on increasing reimbursed access to TearCare with both Medicare payers as well as commercial payers. We're having continued good conversations across the payer mix, really focused on the SAHARA data, the health economic data, and also showing claims utilization and interest in the procedure. We are, of course, building a category here. It does take time. We still expect to have additional payer wins in 2026. It is hard to predict exact timing there, but we fundamentally don't feel any different about our ability to get payer wins over time here to get access to this technology for our patients and our ECP provider partners.

Speaker #4: We're having continued good conversations across the payer mix, really focused on the Sahara data, the health economic data, and also showing claims utilization and interest in the procedure.

Speaker #4: And so we are, of course, building a category here. It does take time. We still expect to have additional payer wins in 2026. It is hard to predict exact timing there, but we fundamentally don't feel any different about our ability to get payer wins over time here.

Speaker #4: To get access to this technology for our patients and our ECP provider partners. I will say that we do have some incremental positive movement with there are some commercial payers that are paying regularly while they haven't established coverage policies.

Ali Bauerlein: I will say that we do have some, you know, incremental positive movement. There are some commercial payers that are paying regularly while they haven't established coverage policies. You know, there are payers that are moving towards those types of activities, and, you know, we feel good about it. In terms of guidance, yes, we still feel extremely confident. The guidance is put in place that only takes into account First Coast and Novitas' fee schedules in place for 2026. Really that market potential alone is still very large for us. We're still a very small fraction of the patients that have moderate to severe dry eye disease with MGD, even within that traditional Medicare fee-for-service population.

Speaker #4: There are payers that are moving towards those types of activities, and we feel good about it. In terms of guidance, yes, we still feel extremely confident.

Speaker #4: The guidance is put in place that only takes into account first coast and Novotel fee schedules in place for 2026. And really, that market potential alone is still very large for us.

Speaker #4: We're still a very small fraction of the patients that have moderate to severe dry eye disease. With MGD, even within that traditional Medicare fee-for-service population.

Speaker #4: So very much early stages and it's a large market and we feel very good that we've set appropriate guidance taking into account all of those factors for the areas where we currently have fee schedules established.

Ali Bauerlein: Very much early stages, and it's a large market, and we feel very good that we've set appropriate guidance, taking into account all of those factors for the areas where we currently have fee schedules established.

Speaker #5: That's great color. I'll jump back in the queue. Thank you.

Adam Maeder: That's great color. I'll jump back in the queue. Thank you.

Speaker #1: Thank you. Our next question comes from the line of Steve Lichtman of William Blair. Your line is now open.

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

Speaker #6: Thank you. Evening, guys, and congratulations on the progress. Wondering now if you could talk about customer accounts for dry eye in the regions that you are approved with reimbursement.

Steven Lichtman: Thank you. Evening, guys, and congratulations on the progress. Wondering, Ellie, if you could talk about customer accounts for dry eye in the regions that you are approved with reimbursement. What's your latest view on sort of the denominator, the number of viable centers that you think are target sets for you within the regions that you're currently in?

Steve Lichtman: Thank you. Evening, guys, and congratulations on the progress. Wondering, Ellie, if you could talk about customer accounts for dry eye in the regions that you are approved with reimbursement. What's your latest view on sort of the denominator, the number of viable centers that you think are target sets for you within the regions that you're currently in?

Speaker #6: What's your latest view on, sort of, the denominator—the number of viable centers that you think are target sets for you within the regions that you're currently in?

Speaker #4: Yeah. I'm going to shift that question a little bit and talk about ECPs eye care providers because that's an easier way of thinking about this.

Ali Bauerlein: Yeah. I'm gonna shift that question a little bit and talk about ECPs, eye care providers, because that's an easier way of thinking about this opportunity. When we talk about across the US, really the targeted providers that do a lot of prescription eye drops, do procedural interventions for dry eye, have strong populations of patients here. We've talked about historically about 6,500 ECPs fall into that bucket as kind of that initial target population. Within First Coast and Novitas, there's 2,000 ECPs that would meet that same criteria. We are still very small. Obviously, active accounts is a little different than eye care provider counts.

Speaker #4: Opportunity. When we talk about across the US, really the targeted payers that are targeted providers that do a lot of prescription eye drops, do procedural interventions for dry eye, have strong populations, patients here.

Speaker #4: We've talked about historically about 6,500 ECPs fall into that bucket as kind of that initial target population. Within first coast and Novotel, there's 2,000 ECPs that would meet that same criteria.

Speaker #4: So we are still very small. Obviously, active accounts is a little different than eye care provider counts. But even with there being a couple ECPs per active account, we're still very much in the early penetration days of the opportunity within first coast and Novotel.

Ali Bauerlein: Even with, you know, there being a couple ECPs per active account, we're still very much in the early penetration days of the opportunity within First Coast and Novitas.

Speaker #1: Great. And then just to follow up on the patent suit, obviously, a decent amount of cash pending here for you guys. Either Paul, Jim, can you talk about the next steps here?

Steven Lichtman: Great. Then just to follow up on the patent suit. Obviously, you know, a decent amount of cash, you know, pending here for you guys. Either Paul or Jim, can you talk about the next steps here? I think Alcon has an opportunity to potentially appeal, but within the next couple weeks or there could be a settlement. You know, what's the next steps? Remind us of the interest accrual, if it does go to appeal.

Steve Lichtman: Great. Then just to follow up on the patent suit. Obviously, you know, a decent amount of cash, you know, pending here for you guys. Either Paul or Jim, can you talk about the next steps here? I think Alcon has an opportunity to potentially appeal, but within the next couple weeks or there could be a settlement. You know, what's the next steps? Remind us of the interest accrual, if it does go to appeal.

Speaker #1: I think Alcon has an opportunity to potentially appeal, but within the next couple of weeks, if that or there could be a settlement. What's the next steps?

Speaker #1: And remind us of the interest accrual if it does go to appeal.

Speaker #5: Yeah. So I can give an update on at least the amounts. So in April of this year, final judgment was issued. And that preserved the jury verdict from 2024.

Jim Rodberg: I can give an update on at least the amounts. In April of this year, final judgment was issued, and that preserved the jury verdict from 2024. That awarded us updated damages, interest, and royalties 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 obviously until such time, when appeals would be exhausted and cash would change hands, for example. The final judgment is subject to appeal, and beyond that, we won't comment further on pending litigation. We feel we are in a very strong position in this case.

Speaker #5: That awarded us updated damages, interest, and royalties of approximately $55 million. As well as ongoing royalties of 10% of future Hydra sales through the patent expiration.

Speaker #5: We have not received any cash to date. And we will not book anything obviously until such time when appeals would be exhausted and cash would change hands, for example.

Speaker #5: The final judgment is subject to appeal. And beyond that, we won't comment further on pending litigation, but we feel we are in a very strong position in this case.

Speaker #1: Okay, great. Thanks, Jim. Thanks, everyone.

Steven Lichtman: Okay, great. Thanks, Jim. Thanks, everyone.

Steve Lichtman: Okay, great. Thanks, Jim. Thanks, everyone.

Speaker #5: Thanks.

Jim Rodberg: Thanks.

Speaker #1: Thank you. Our next question comes from a line of Tom, Stefan of Steeple. Your line is now open.

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

Speaker #5: Great. Hey, guys. Thanks for taking the questions. First one on dry eye. Nice to see the guidance phrase already really strong sequential growth in utilization.

Thomas Stephan: Great. Hey, guys. Thanks for taking the questions. First 1 on dry eye. Nice to see the guidance raise, already really strong sequential growth in utilization. Maybe I'll just ask sort of a big picture question. Like, what have been, call it the top 1 or 2 upside surprises or learnings, amidst kind of this relaunch, if you will? Part 2 to that, how do you feel about the playbook you're developing for when different markets and patient populations hopefully unlock and sort of your ability to deploy that quickly? I'll leave it there. Thanks.

Tom Stephan: Great. Hey, guys. Thanks for taking the questions. First 1 on dry eye. Nice to see the guidance raise, already really strong sequential growth in utilization. Maybe I'll just ask sort of a big picture question. Like, what have been, call it the top 1 or 2 upside surprises or learnings, amidst kind of this relaunch, if you will? Part 2 to that, how do you feel about the playbook you're developing for when different markets and patient populations hopefully unlock and sort of your ability to deploy that quickly? I'll leave it there. Thanks.

Speaker #5: Maybe I'll just ask sort of a big picture question. What have been call it the top one or two upside surprises or learnings amidst kind of this relaunch, if you will?

Speaker #5: And part two to that, how do you feel about the playbook you're developing for and patient populations hopefully unlock and sort of your ability to deploy that quickly?

Speaker #5: I'll leave it there. Thanks.

Speaker #4: Yeah. So one to two areas we've had a lot of learnings since launch. And most of them have been very positive, both about how large of an opportunity this is, how many patients really are looking for a better treatment.

Ali Bauerlein: Yeah. We've had a lot of learnings since launch, and most of them have been very positive, both about how large of an opportunity this is, how many patients really are looking for a better treatment, but also the synergies with our IG business. That's probably the largest benefit that we've seen, is that 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 looking for ways to help their patients who also experience a significant amount of dry eye. That is a very large part of our initial launch here, initial success. We also see that those accounts are having higher utilization than the non-IG synergistic accounts.

Speaker #4: But also the synergies with our IG business. That's probably the largest benefit that we've seen is that 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.

Speaker #4: And they are looking for ways to help their patients who also experience a significant amount of dry eye. And so, that is a very large part of our initial launch here, initial success.

Speaker #4: And we also see that those accounts are having higher utilization than the non-IG synergistic accounts. So really positive momentum there. And good synergies across the team.

Ali Bauerlein: Really positive momentum there and good synergies across the team. In terms of the playbook and what we see as we move forward here, there is still a lot of workflow activation that needs to occur when account decides that they want to implement procedural dry eye. We do think that this is involved with people really being in accounts and helping the clinic set up their workflow, identify the patients, and identify how best to put them into a dry eye treatment workflow. Because of that, we do think that as we have additional market access wins, particularly in new geographies, that will involve additional commercial investments as we grow the team and of course, work with the accounts that we already have in those areas as well.

Speaker #4: In terms of the playbook and what we see as we move forward here, there is still a lot of workflow activation that needs to occur when account decides that they want to implement procedural dry eye.

Speaker #4: So we do think that this is involved with people. People really being in accounts and helping the clinic set up their workflow, identify the patients, and identify how best to put them into a dry eye treatment workflow.

Speaker #4: And so, because of that, we do think that as we have additional market access wins, particularly in new geographies, that will involve additional commercial investments as we grow the team.

Speaker #4: And of course, work with the accounts that we already have in those areas as well. And then as we have additional density happening with additional payers coming on in already markets where we have Medicare fee schedules, those are easier to activate because those accounts, it's just adding new payers that can process and add those patients into that same workflow.

Ali Bauerlein: As we have additional density happening with additional payers coming on in already markets where we have Medicare fee schedules, those are easier to activate because those accounts, it is just adding new payers that can process and add those patients into that same workflow. Over time, that may also shift the accounts that we are targeting. We are targeting right now a lot of those higher volume ophthalmology practices that do have a lot of Medicare patients, which is where we are seeing the synergies with IG. Over time, that population may shift where we know when we look at the dry eye disease market, 70% of patients are covered by commercial plans, and 30% are being covered by Medicare or Medicare Advantage plans. Right now, we are targeting a subset of a subset there.

Speaker #4: Over time, that may also shift the accounts that we're targeting as you know, we are targeting right now a lot of those higher volume ophthalmology practices that do have a lot of Medicare patients, which is where we're seeing the synergies with IG.

Speaker #4: Over time, that population may shift where we know that there is when we look at the dry eye disease market, 70% of patients are covered by commercial plans and 30% are being covered by Medicare or Medicare Advantage plans.

Speaker #4: And so right now, we're targeting a subset of a subset there. As we get the commercial plans, that can really shift our strategy in terms of account targeting and where we look to really partner with people.

Ali Bauerlein: As we get the commercial plans, that can really shift our strategy in terms of account targeting and where we look to really partner with people. We're really happy with the progress we've seen in terms of creating a workflow within accounts, and it is being replicated very efficiently across accounts, so they can work TearCare into their procedure flow, whether that's I'm going to have a TearCare day, or I'm going to have multiple TearCare afternoons, or TearCare mornings. They tend to stack them up in the day to be efficient. All of that is being worked through, and then we're having the assessments upfront to identify those patients that may benefit from a procedural dry eye intervention and working that into the workflow.

Speaker #4: But we're really happy with the progress we've seen in terms of creating a workflow within accounts. And it is being replicated very efficiently across the accounts so they can work tier care into their procedure flow, whether that's I'm going to have a tier care day or I'm going to have multiple tier care afternoons or tier care mornings.

Speaker #4: They can do stack them up in the day to be efficient. But all of that is being worked through. And then we're having the assessments upfront to identify those patients that may benefit from a procedural dry eye intervention and working that into the workflow.

Speaker #4: So, a lot of different things coming together right now, but we do think we're in a good spot to continue to execute across this new area.

Ali Bauerlein: A lot of different things coming together right now, but we do think we're in a good spot to continue to execute across this new area.

Speaker #1: And Tom, I just want to add a few thoughts to Allie's comments around the intersection. Site Sciences started we were born interventional. We started with Omni and then we developed tier care.

Jim Rodberg: Tom, I just wanna add a few thoughts to Ali's comments around the intersection. At Sight Sciences started, we were born interventional. We started with OMNI, and then we developed TearCare. These are two very strong interventions for two of the leading diseases in eye care. While that's been our philosophy, I think what we've seen and we've been pleasantly surprised by is the rate at which.

Paul Badawi: Tom, I just wanna add a few thoughts to Ali's comments around the intersection. At Sight Sciences started, we were born interventional. We started with OMNI, and then we developed TearCare. These are two very strong interventions for two of the leading diseases in eye care. While that's been our philosophy, I think what we've seen and we've been pleasantly surprised by is the rate at which.

Speaker #1: These are two very strong interventions for two of the leading diseases in eye care. So, while that's been our philosophy, I think what we've seen—and we've been pleasantly surprised by—is the rate at which our customers, and specifically surgeons, as Allie mentioned, have recognized the overlap of these two disease categories and the possibilities of offering these same patients multiple interventions.

Paul Badawi: Our customers, and specifically surgeons, as Ali mentioned, 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 faster, I'd say, than even we expected. When we go out in the field and we meet with our, you know, our happy OMNI surgeons and we're working with our dedicated commercial team, it's amazing how many of our glaucoma surgeons talk about how many of their glaucoma patients have dry eye disease, and they're complaining about their dry eye disease because you can feel that. They're not complaining about their glaucoma because it's a silent disease, unfortunately.

Speaker #1: So the alignment between the ophthalmic community and our philosophy of building an interventional eye care company has come faster, I'd say, than even we expected.

Speaker #1: When we go out in the field and we meet with our happy Omni surgeons and we're working with our dedicated commercial team, it's amazing how many of our glaucoma surgeons talk about how many of their glaucoma patients have dry eye disease and they're complaining about their dry eye disease.

Speaker #1: Because you can feel that. They're not complaining about their glaucoma because it's a silent disease, unfortunately. And so the us being able to show up as their interventional partner having an intervention for their glaucoma patient, having an intervention for their glaucoma patient who also has dry eye disease, it's a very powerful partnership.

Paul Badawi: The, you know, us being able to show up as their interventional partner, having an intervention for their glaucoma patients, having an intervention for their glaucoma patient who also has dry eye disease, it's a very powerful partnership. I think we're surprised and very happy about how fast the community is acknowledging that. We're calling it, again, internally, IX. It's the intersection of intervention. It's this proprietary angle we have, and we're looking forward to, like, driving the benefits and the synergies of these interventional platforms to reach more patients with better interventions, offering better care more quickly.

Speaker #1: And I think we're surprised and very happy about how fast the community is acknowledging that. We're calling it again internally IX. It's the intersection of intervention; it's this proprietary angle we have.

Speaker #1: And we're looking forward to driving the benefits and the synergies of these interventional platforms to reach more patients, with better interventions offering better care, more quickly.

Speaker #2: Thank you. Our next question comes from the line of Joanne Vunch of Citi. Your line is now open.

Operator: Thank you. Our next question comes from the line of Joanne Wuensch of Citi. Your line is now open.

Speaker #3: Hey, good afternoon and thanks for taking the question. You seem to be making a fair amount of progress on expense management, cash management, and everything else that goes along with it.

Joanne Wuensch: Hey, good afternoon, and thanks for taking the question. You seem to be making a fair amount of progress on expense management, cash management, and everything else that goes along with it. Can you sort of give us a view on your philosophy of how do you balance everything that you're doing in terms of penetrating the MACs and educating the physicians and ramping them with the other metrics that, you know, we come to view and love in on the side of Wall Street? Thank you.

Speaker #3: Can you sort of give us a view on your philosophy of how do you balance everything that you're doing in terms of penetrating the max and educating the physicians and ramping them with the other metrics that we come to view and love in the side of Wall Street?

Speaker #3: Thank you.

Speaker #1: Hey, Joanne. Thanks for the question. I'll take that one and Paul and Allie can add as needed here. But we're in a really good spot with a really healthy balance sheet and a strong pathway to cash flow breakeven.

Jim Rodberg: Hey, Joanne. Thanks for the question. I'll take that one, and Paul and Ali can add as needed here. We're in a really good spot with a really healthy balance sheet and a strong pathway to cash flow break even, while at the same time having the ability to go invest in these two significant opportunities. As we look at 2026, the most important investments for us this year are on the dry eye side, both in market access resources as well as commercial resources to scale up that business in markets where we already have reimbursement. Then on the glaucoma side, continuing to invest in the stand-alone opportunity there.

Speaker #1: While at the same time having the ability to go invest in these two significant opportunities, as we look at 2026, the most important investments for us this year are in on the dry eye side, both in market access resources as well as commercial resources, to scale up that business in markets where we already have reimbursement.

Speaker #1: And then on the glaucoma side, continuing to invest in the standalone opportunity there. So the balance for us is we want to make disciplined high-return investments and we're fortunate, I think, to have the flexibility to go faster on some of those investments where there's outsized opportunity for growth.

Jim Rodberg: The balance for us is we want to make disciplined, high return investments, and we're fortunate, I think, to have the flexibility to go faster on some of those investments where there's outsized opportunity for growth.

Speaker #4: And the only thing I would add to that, Joanne, on the R&D front, look, we have a history of developing cost-effectively developing clinically differentiated interventions that can elevate the standard of care.

Paul Badawi: The only thing I would add to that, Joanne, on the R&D front. Look, we have a history of developing, cost-effectively developing, clinically differentiated interventions that can elevate the standard of care. I think we've done that well with OMNI. We've done that well with TearCare. We've got a number of, you know, selective R&D programs that we're investing in that we're gonna be very excited about, you know, all within this interventional category as we build, you know, a focused interventional eye care company. We've got very interesting pipeline that we're developing cost-effectively, and in due course, we're looking forward to sharing more about that, hopefully later this year.

Speaker #4: I think we've done that well with Omni. We've done that well with tier care. We're making very selective we've got a number of selective R&D programs that we're investing in that we're going to be very excited about.

Speaker #4: All within this interventional category, as we build a focused interventional eye care company, but we've got very interesting pipeline that we're developing cost-effectively. And in due course, we're looking forward to sharing more about that hopefully later this year.

Speaker #3: Wonderful. Thank you.

Joanne Wuensch: Wonderful. Thank you.

Speaker #2: Thank you. Our next question comes from the line of David Saxon of Needham & Company. Your line is now open.

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

Speaker #1: Great. Good afternoon, Paul, Allie, and Jim. Thanks for taking my questions. So I wanted to ask a similar question to Adam's, but from a slightly different angle.

David Saxon: Great. Good afternoon, Paul, Ali, and Jim. Thanks for taking my questions. I wanted to ask a similar question to Adam's, but from a slightly different angle. I think you're only in 4 of the 13 states in First Coast and Novitas, those two regions or jurisdictions, I should say. Does the guide assume you get into any more of those states, or is the 6 to 8 really just reflective of presence in, like, a fraction of the total, you know, immediate opportunity?

Speaker #1: So I think you're only in four of the 13 states in First Coast and Nova Toss. Those two regions or jurisdictions, I should say.

Speaker #1: So does the guide assume you get into any more of those states or is the 6 to 8 really just reflective of presence in a fraction of the total immediate opportunity?

Speaker #4: Yeah. So to your point, we have sales really across first of all, most of the 13 states, we have some level of sales. So we do have some sales support across them.

Ali Bauerlein: To your point, we have sales really across. First of all, most of the 13 states, we have some level of sales. We do have some sales support across them. You are right, we do have density within 4 or 5 main states that have the majority of the sales resources in them. We do expect to continue to expand the resources there, whether we expand them within those specific 4 to 5 states, as there are still opportunities. As you can imagine, you know, 1 rep in Florida would not be sufficient to cover the entire state of Florida, for example. We are looking at where we invest those resources. The plan does take into account that we do have incremental investments in commercial resources in those areas.

Speaker #4: But you are right, we do have density within four or five main states that have the majority of the sales resources in them. We do expect to continue to expand the resources there, whether we expand them within those specific four to five states as there are still opportunities, as you can imagine, one rep in Florida would not be sufficient to cover the entire state of Florida for example.

Speaker #4: So, we are looking at where we invest those resources. The plan does take into account that we do have incremental investments in commercial resources in those areas.

Speaker #4: We aren't going to get into specific territories or how we're going to break that out, but all of that is accounted for in our operating expense guidance.

Ali Bauerlein: We aren't gonna get into specific territories or how we're going to break that out. All of that is accounted for in our operating expense guidance. We have already adjusted for that appropriately.

Speaker #4: So we have already adjusted for that appropriately.

Speaker #1: Okay. Thanks for that. And then on the IG side, Paul or Allie would love to get an update on Omni Ultra. Timing of that clearance and is that embedded in the IG revenue guidance or would that be upside when that comes out?

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

Speaker #1: Thanks so much.

Speaker #5: Yeah, David, this is Paul. We are in discussions with the FDA on Omni Ultra. We well, nothing is definitive as everybody knows with 510(k) clearance pathways.

Paul Badawi: Yeah, David, this is Paul. We are in discussions with the FDA on OMNI Ultra. Well, you know, nothing is definitive, as everybody knows, with 510(k) clearance pathways. We feel confident that we should have a clearance, hopefully within the coming months, certainly by the end of the year. We're very excited to launch Ultra again, hopefully by the end of the year, it'll be out in the market. It's got a number of great features, surgeon-informed. We obviously partner very closely all the time with our surgeons and take their feedback to continue to innovate in IG and move the OMNI platform forward and stay ahead. It's got, you know, single pass, single incision, single pass 360.

Speaker #5: We feel confident that we should have a clearance, hopefully within the coming months, certainly by the end of the year. So we're very excited to launch Ultra again, hopefully by the end of the year.

Speaker #5: It'll be out in the market. It's got a number of great features, surge in informed. We're obviously partner very closely all the time with our surgeons and take their feedback to continue to innovate in IG and move the Omni platform forward and stay ahead.

Speaker #5: It's got single pass, single incision, single pass, 360. It's got viscoelastic delivery on both advancement and retraction. Which is a really nice feature. It's got markings on the catheter to tell the surgeon how far they've advanced.

Paul Badawi: It's got viscoelastic delivery on both advancement and retraction, which is a really nice feature. It's got markings on the catheter to tell the surgeon how far they've advanced. It's got, you know, better ergonomics. The handle has better ergonomics. It's got a number of features that we think will help elevate this category even further. Hopefully it's getting released by the end of the year. We don't know when, ultimately can't predict with specificity when the clearance will come. I can say this, we've 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.

Speaker #5: It's got better ergonomics. The handle has better ergonomics. It's got a number of features that we think will help elevate this category even further.

Speaker #5: Hopefully, it's getting released by the end of the year. We don't know when ultimately can't predict with specificity when the clearance will come. I can say this.

Speaker #5: We've 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.

Speaker #1: Great. Thanks so much.

David Saxon: Great. Thanks so much.

Speaker #2: Thank you. This concludes the question and answer session. I would now like to turn it back to Paul Badawi for closing remarks.

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

Speaker #5: Thank you all for attending today's call. We appreciate your interest in site sciences and we look forward to updating you on our progress in the future.

Paul Badawi: Thank you all for attending today's call. We appreciate your interest in Sight Sciences. We look forward to updating you on our progress in the future.

Operator: Thank you for your participation in today's conference. This does conclude the program. You may now disconnect.