Sight Sciences, Inc. Common Stock 2026 Q2 Earnings Call

Please go ahead. 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, James Rodberg. Also in attendance is Sight Sciences Chief Operating Officer, Ali Bauerlein. Earlier today, Sight Sciences released financial results for the second quarter ended June 30, 2026, and raised its revenue guidance and lowered 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 our projected financial results, including revenue and adjusted operating expenses, our product development plans, market acceptance of our products, changes in the reimbursement environment, and our ability to drive profitability and achieve cash flow break even.

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. For a discussion of factors that may affect the company's future financial results in business, please refer to the earnings release issued prior to this call in 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 U.S., 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.

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 will now turn the call over to Paul.

Thanks, Trip. Good afternoon, and thank you for joining us. We delivered a strong second quarter with revenue growing 20% year-over-year, our highest growth rate since 2023, and our second consecutive quarter of double-digit growth. This performance reflected growth in both segments, with interventional dry eye achieving record revenue as TearCare adoption scaled in the reimbursed market, and interventional glaucoma delivering its highest year-over-year growth rate since the fourth quarter of 2024. Importantly, we achieved this growth while significantly improving operating results and meaningfully reducing cash usage. As a result of this strong performance, we are raising our full year 2026 revenue guidance and reducing our adjusted operating expense guidance.

At Sight Sciences, we are focused on advancing interventional eye care with innovative, minimally invasive technologies that address two of the most prevalent diseases in the anterior segment of the eye: glaucoma and dry eye disease. Across both categories, there is a growing interventional mindset. We believe providers are increasingly seeking procedure-based treatment options that comprehensively address the underlying causes of disease in a minimally invasive manner and fit naturally into clinical workflows. We believe Sight Sciences is differentiated by our focus on enabling earlier procedure-based care across these two large and complementary disease states. Both OMNI and TearCare were purpose-built to support this evolution toward minimally invasive treatment options for providers and patients. Beyond the individual growth opportunities of each platform, we see a broader strategic advantage in what we call the intersection of intervention.

Glaucoma and dry eye disease often affect the same patients, are treated within the same practices, and fit within similar procedural workflows. This overlap creates opportunities to deepen customer relationships, increase account utilization, improve the patient care pathway, and drive durable growth while reinforcing Sight Sciences' leadership in interventional eye care. Now, turning to our segments, starting with interventional dry eye. We are pioneering the reimbursed interventional dry eye treatment market. We delivered another strong quarter with record revenue of $2.7 million, nearly doubling from the first quarter of 2026. As we build this significant category, the commercial signals continue to strengthen. We are also proud to have added approximately $4.1 million patient lives in the second quarter, during which certain insurance plans have published fee schedules in their provider portals that align with the updated Medicare pricing established in certain jurisdictions last year.

This has increased our TearCare patient lives with access to appropriate reimbursement from approximately $10.4 million-$14.5 million. Based on this revenue and reimbursement momentum, we are raising our interventional dry eye guidance to a range of $9 million-$11 million, up from the previous range of $6 million-$8 million. The continued strong performance in our dry eye business was driven by strength in two key metrics, account growth and utilization. Ordering accounts increased from 96 in the first quarter to 176 in the second quarter and included a healthy combination of new and reordering accounts. These accounts purchased more than 3,000 SmartLids in the quarter, more than double our first quarter volumes. Importantly, even as the active account base nearly doubled, average utilization also increased to approximately 18 SmartLids per active account in the second quarter, up from 16 in the first quarter.

We also saw meaningful evidence of the value created by the overlap between our two interventional segments. In the second quarter, approximately two-thirds of SmartLids volume came from accounts that are also interventional glaucoma customers, and those overlapping accounts had significantly higher utilization than our interventional dry eye-only accounts. This reinforces our view that our established interventional glaucoma relationships can help accelerate TearCare adoption, deepen customer engagement, and create a more efficient path to growth in interventional dry eye. The commercial traction we are seeing with TearCare reinforces our conviction in the reimbursed procedural dry eye category. While we remain in the early stages of developing this market, we believe we are building a durable and efficient recurring revenue business model that can scale across additional territories as market access expands.

Our commercial strategy remains focused on driving adoption and accounts with a history of significant dry eye prescription activity, coupled with an interventional mindset where we believe TearCare can fit naturally into practice workflow and patient care. We added sales and clinic support headcount in the second quarter and will continue making investments in our commercial infrastructure to strengthen our team and equip providers with the support needed to adopt and grow their interventional dry eye practices. Over time, we see meaningful runway for growth as practices continue building patient funnels and integrating TearCare into their workflows. The adoption we are seeing also reflects TearCare's clinical outcomes, ease of use, office workflow compatibility, and value proposition for patients, providers, and payers. Expansion of our interventional dry eye segment to its full potential will be enabled by additional market access.

We continue to advance this priority through productive dialogue with multiple MACs and continue to anticipate that additional payers will establish fee schedules and/or coverage policies this year. At the same time, we remain focused on executing within the currently serviceable market already in front of us. We believe continued execution in these regions can drive meaningful growth with additional positive payer decisions serving as important accelerators. Considering the encouraging TearCare adoption trajectory, ongoing payer engagement, and differentiated clinical profile, we remain very well positioned to continue pioneering the development of the reimbursed interventional dry eye category and drive meaningful long-term growth in this business. Turning to interventional glaucoma, OMNI remains foundational to our interventional eye care platform and a key reason we are well positioned as the interventional mindset continues to expand across both glaucoma and dry eye.

Since commercialization, OMNI has enabled us to build deep relationships with surgeons and practices by offering a proven, minimally invasive, implant-free procedure that fits naturally into the glaucoma treatment pathway. This established base of customers, along with successful clinical experiences, procedural credibility, and strong partnership, all support continued growth in interventional glaucoma while also strengthening our commercialization within interventional dry eye. In the second quarter, we achieved our fourth consecutive quarter of year-over-year growth, with revenue of $20.7 million, up 8% versus the same period in the prior year. Growth was broad-based, with strength across all key metrics, including increases in active accounts, volumes, utilization, and pricing. Ordering accounts reached an all-time high in the quarter and increased 3% year over year. Importantly, utilization returned to its highest level since the fourth quarter of 2024 when LCDs began to adversely impact MIGS volumes.

We are encouraged by the progress in the first half of the year, the underlying trends support our expectation for continued interventional glaucoma growth in the second half of 2026. As a result, we are narrowing to the high end of the range for our interventional glaucoma revenue guidance to $79 million-$81 million, up from our previous range of $77 million-$81 million. We are also pleased to highlight that in July, coverage of OMNI and SION expanded with the addition of approximately $25 million covered lives from Aetna, one of the largest health plans in the U.S. Aetna now recognizes certain implant-free glaucoma procedures as medically necessary for mild to moderate open-angle glaucoma when specified clinical criteria are met.