Sight Sciences (NASDAQ:SGHT) reported fourth-quarter 2025 results highlighting growth in both its interventional glaucoma and interventional dry eye segments, alongside what management described as continued operating expense discipline and cash management. The company also initiated 2026 revenue guidance and adjusted operating expense guidance, with leadership emphasizing a strategy to return to double-digit growth while maintaining “operational rigor and financial discipline.”
Company reframes business around “interventional” focus
Co-founder and CEO Paul Badawi said the company has updated how it describes its business segments, shifting from “surgical glaucoma” and “dry eye” to interventional glaucoma and interventional dry eye. Badawi said the change reflects Sight Sciences’ focus on earlier procedure-based interventions aimed at elevating standards of care.
Interventional dry eye: reimbursement milestone and early commercial traction
Badawi said the company achieved a “very important reimbursement milestone” in the fourth quarter when Medicare Administrative Contractors CGS, Novitas Solutions, and First Coast Service Options established pricing for CPT code 0563T, which is associated with the TearCare procedure. He called the fee schedule developments a turning point and said the company is executing a strategy aimed at “pioneering the reimbursed interventional dry eye treatment market.”
Interventional dry eye revenue was $0.7 million in the fourth quarter, up sequentially and from $0.3 million in the prior-year quarter. Badawi said revenue was driven by sales of approximately 700 SmartLids to approximately 80 accounts, with roughly 30 new account engagements. He added that growth in the quarter was “largely driven” by sales in the Novitas and First Coast regions, where customer engagement has been strong since the reimbursed launch.
Management said it is focusing on high-volume dry eye prescribers and engaging new providers in states with newly established fee schedules. Badawi also said some new TearCare customers are existing OMNI glaucoma customers, describing TearCare as a natural complement to current practice offerings in those markets.
As the business scales, the company said it is making additional investments in its interventional dry eye commercial organization, including market access efforts and expanded commercial infrastructure in markets with established reimbursement.
Interventional glaucoma: growth after lapping LCD headwinds
Badawi said the fourth quarter represented a milestone because the company “fully lapped” local coverage determination (LCD) changes that restricted multiple MIGS procedures in combination with cataract surgery. Management said those LCDs reduced the number of devices used and created headwinds to market growth in 2025.
Despite those headwinds, Sight Sciences reported fourth-quarter interventional glaucoma revenue of $19.7 million, up 5% year over year and flat sequentially. Badawi said ordering accounts increased 2% from the prior year due to a combination of reactivated and new accounts, while utilization was “down only slightly” after a strong third quarter. The company also cited higher OMNI Edge utilization as a driver of higher average selling prices.
Management said it is increasingly focused on developing the standalone glaucoma market and is investing in targeted commercial resources to drive “pseudophakic education and activation.” Badawi described an “interventional glaucoma evaluation workflow” modeled after the cataract surgery consult process, intended to improve activation by bringing candidates back for dedicated interventional glaucoma consult visits.
In the Q&A, Badawi estimated the overall MIGS market mix at roughly 90% combo cataract and 10% standalone in revenue terms, and said Sight Sciences’ mix is “mid-80s combo cataract” and “mid-teens standalone.” He added the company has “about a half a dozen” market development-focused professionals working to expand standalone adoption.
Financial results and 2026 outlook
CFO Jim Rodberg said the company is entering 2026 “from a position of strength,” citing operating discipline and a cost structure intended to support growth. Rodberg added that over time the company believes it can achieve cash flow breakeven “without the need to raise additional equity capital.”
- Total revenue: $20.4 million, up 7% year over year
- Gross margin: 87%, consistent with the prior year
- Interventional glaucoma gross margin: 88% (vs. 87%), driven by higher ASPs and mix, slightly offset by tariff costs
- Interventional dry eye gross margin: 68% (vs. 51%), primarily due to higher ASPs
- Total operating expenses: $21.5 million, down 25% from $28.5 million, primarily due to lower personnel-related expenses and stock-based compensation
- Adjusted operating expenses: $18.9 million, down 23% from $24.4 million
- Net loss: $4.2 million, or $0.08 per share (vs. $11.8 million, or $0.23 per share)
- Cash and cash equivalents: $92.0 million at quarter-end (vs. $120.4 million at the end of 2024)
- Quarterly cash usage: $0.4 million, which Rodberg called the lowest cash usage quarter of the year
- Debt: $40.0 million at year-end, unchanged from 2024 (excluding unamortized discount and issuance costs)
For full-year 2026, Sight Sciences guided revenue of $82 million to $88 million, representing 6% to 14% growth versus 2025. The outlook includes:
- Interventional glaucoma revenue: $77 million to $81 million (2% to 7% growth)
- Interventional dry eye revenue: $5 million to $7 million (vs. $1.6 million in 2025)
Rodberg said the company expects interventional glaucoma to grow low single digits in the first quarter compared to the prior-year period, and described the first quarter as likely the lowest quarter of the year for that segment, with the second half expected to be higher than the first. For interventional dry eye, the company expects approximately $1 million of revenue in the first quarter, with revenue ramping throughout the year as the reimbursed TearCare launch scales.
Sight Sciences also guided 2026 adjusted operating expenses of $93 million to $96 million, up 6% to 9% from 2025, driven primarily by targeted market access and commercial investments in both segments.
During Q&A, management said storms across the U.S. in January and February were a factor impacting the first quarter. Executives also discussed ongoing engagement with additional Medicare Administrative Contractors and commercial payers for TearCare, stating they expect more MACs to establish fee schedules in 2026 but did not provide specific timing. On a separate reimbursement topic, management noted awareness of potential future revaluation of goniotomy codes, which they said would not take effect until January 2028 if implemented.
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.
