Sight Sciences Q1 Earnings Call Highlights

Key Points

• Sight Sciences reported a “strong start” to 2026 with total Q1 revenue of $19.7 million, up 13% year-over-year, gross margin of 86%, a narrower net loss of $13.0 million, and cash of $85 million while quarterly cash usage fell to $7 million.
• Interventional Dry Eye revenue nearly doubled sequentially to $1.4 million driven by ~1,500 SmartLids sold (vs. ~700 in Q4), prompting management to raise dry eye guidance and project $6–8 million for the full year.
• Management raised full-year revenue guidance to $83–$89 million and kept adjusted operating expense guidance of $93–$96 million, while a court upheld a ~ $55 million past-damages judgment (plus ongoing royalties) in patent litigation with Alcon that is subject to appeal and not yet collected; the company says it is positioned to reach cash-flow breakeven without raising equity.

Sight Sciences NASDAQ: SGHT reported first-quarter 2026 results that management said marked a “strong start” to the year, highlighted by a return to double-digit revenue growth, steady gross margin performance, and lower cash usage. The company also raised its full-year 2026 revenue guidance while maintaining its adjusted operating expense outlook.

First-quarter results show growth in both segments

Co-Founder and CEO Paul Badawi said the company delivered “a strong start to 2026” with results reflecting “a return to double-digit revenue growth, continued strength in gross margin, and disciplined operating expense and cash management.”

CFO Jim Rodberg reported total revenue of $19.7 million in the first quarter, up 13% year over year, “driven by growth in each of our two Interventional segments.” Gross margin was 86%, flat compared to the prior-year period.

• Interventional Glaucoma (OMNI): Revenue of $18.3 million, up 7% year over year.
• Interventional Dry Eye (TearCare): Revenue of $1.4 million, up from $0.4 million in the prior-year period and “nearly doubling” from the fourth quarter of 2025.

Rodberg said net loss was $13.0 million, or $0.24 per share, compared with a net loss of $14.2 million, or $0.28 per share, in the year-ago quarter. The company ended the quarter with $85 million in cash and cash equivalents, down from $92 million at the end of 2025, and reported $7 million of cash used in the quarter versus $11.6 million in the first quarter of 2025.

Interventional Dry Eye nearly doubles sequentially as SmartLids volume increases

Badawi said the company’s Interventional Dry Eye business delivered “continued positive commercial traction,” with revenue nearly doubling from the fourth quarter, which he described as “early validation of our procedural in-office recurring revenue business model.” Based on first-quarter performance, Sight Sciences increased its Interventional Dry Eye revenue guidance by $1 million at the midpoint, according to Badawi.

Badawi attributed the quarter’s $1.4 million in dry eye revenue primarily to disposable SmartLids. He said the company sold approximately 1,500 SmartLids in the quarter, up from about 700 in the fourth quarter of 2025, with sales to 96 accounts comprised of a “balanced mix of new accounts and reordering accounts.” Average SmartLids utilization increased from about nine per active account in the fourth quarter to about 16 per active account in the first quarter.

COO Ali Bauerlein said utilization remains early across the customer base, noting that even the largest accounts are not yet “fully activating this across their patient population.” She added that about 10% of accounts are driving a larger portion of volume and have “really figured out the workflow.”

Management emphasized that early performance has been strongest in the First Coast and Novitas regions, where fee schedules were recently established. Bauerlein told analysts the company’s 2026 dry eye guidance assumes only those two fee schedules and does not require additional payer wins to reach its targets. She said the company remains engaged with multiple Medicare Administrative Contractors and commercial payers, and “still expect[s] to have additional payer wins in 2026,” while cautioning that timing is difficult to predict.

On the size of the opportunity, Bauerlein said the company has historically discussed about 6,500 U.S. eye care providers as an initial target population, with about 2,000 in First Coast and Novitas that meet similar criteria. She also said the company is currently deploying sales resources with “density within four or five main states,” while indicating there is still room to expand coverage even within large states.

Interventional Glaucoma posts third straight quarter of year-over-year growth

In Interventional Glaucoma, Badawi said OMNI delivered the “third consecutive quarter of year-over-year growth,” and pointed to broader market momentum around “earlier intervention” in glaucoma care. He called OMNI “the leading implant-free, micro-invasive glaucoma surgical option in the market.”

Rodberg said the segment’s revenue increase was driven by increases in ordering accounts and average selling prices, partially offset by lower utilization per account. Badawi added that procedure volumes increased in March following “a slower than typical start in January and February,” and said the company saw continued strong adoption of OMNI Edge, which he said supported account reactivation and new account additions.

Ordering accounts increased 6% year over year, driven primarily by reactivating dormant accounts and adding new accounts, according to Badawi. Rodberg added that ordering accounts grew 1% sequentially from the fourth quarter.

Badawi also discussed the company’s approach to expanding both the combo cataract and standalone opportunities in 2026, including training new surgeons and using a dedicated market development team for standalone procedures. He said the team is helping practices introduce a streamlined interventional glaucoma workflow modeled after cataract workflows.

Guidance raised; expense discipline and litigation update

For full-year 2026, Rodberg said the company raised revenue guidance to $83 million to $89 million, up from prior guidance of $82 million to $88 million. The updated outlook includes:

• Interventional Glaucoma: $77 million to $81 million in revenue (2% to 7% growth versus 2025).
• Interventional Dry Eye: $6 million to $8 million in revenue (compared to $1.6 million in the prior year).

For the second quarter, Rodberg said the company expects total revenue to grow “low double digits” year over year, with Interventional Glaucoma revenue expected to grow “mid-single digits.” Interventional Dry Eye revenue is expected to be $1.5 million to $2.0 million in the second quarter, and Rodberg said the company expects that revenue to “continue to scale throughout the year.”

The company reaffirmed full-year 2026 adjusted operating expense guidance of $93 million to $96 million. Rodberg said the year-over-year increase reflects “targeted commercial investments” in both segments, while maintaining operating discipline. He pointed to the company’s reduced cost structure following a reduction in force in the third quarter of 2025, noting the first quarter was the “second full quarter” at that lower structure. Adjusted operating expenses were $21.2 million, down 14% from $24.7 million.

On GAAP operating expenses, Rodberg reported total operating expenses of $29.4 million, up 2% year over year, primarily due to a $5.4 million one-time fee earned upon a successful final judgment in the company’s patent litigation against Alcon.

Badawi and Rodberg provided an update on that case, noting that in April the court issued a final judgment upholding a jury’s finding of willful infringement and confirming approximately $55 million in past damages and interest, along with ongoing royalties of 10% of Hydrus revenue through patent expiration. Rodberg said the ruling is subject to appeal, no cash has been received to date, and the company will not recognize amounts until appeals are exhausted and cash changes hands.

Looking ahead, Rodberg said management believes Sight Sciences is positioned to reach cash flow breakeven “without the need to raise additional equity capital,” while continuing to invest in dry eye market access and commercialization and in expanding the standalone glaucoma opportunity.

About Sight Sciences NASDAQ: SGHT

Sight Sciences, Inc is a medical device company focused on developing and commercializing minimally invasive treatments for chronic eye diseases. The company's flagship products include the OMNI® Surgical System, designed to address multiple points of resistance in the eye's natural drainage pathways to lower intraocular pressure in glaucoma patients, and the TearCare® System, a wearable device for treating meibomian gland dysfunction and dry eye disease through targeted thermal pulsation therapy.

Since its founding in 2012 and subsequent listing on the NASDAQ under the ticker SGHT, Sight Sciences has pursued a strategy of combining research-driven product development with a direct sales force model.

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