Summary of Sight Sciences FY Conference Call (September 10, 2025) Company Overview - **Company**: Sight Sciences (NasdaqGS:SGHT) - **Industry**: Interventional Glaucoma and Dry Eye Treatment Key Points on the MIGS Market - **Market Growth**: The MIGS (Minimally Invasive Glaucoma Surgery) market is expected to return to growth in 2026 after facing headwinds due to LCD (Local Coverage Determinations) and payment changes in 2025 [3][4] - **Clinical Need**: Glaucoma is the leading cause of irreversible blindness globally, necessitating more interventional options for patients [3][5] - **Patient Visits**: There is a continuous increase in patient visits, indicating a growing demand for glaucoma treatments [3][4] - **Commercial Strategy**: The company aims to position itself strongly to capture growth when the MIGS market rebounds, emphasizing the importance of innovation and effective commercial execution [4][10] Insights on Glaucoma Treatment - **Interventional Approaches**: The future of glaucoma treatment is expected to be more interventional, with a focus on sustained release interventions and early use of SLT (Selective Laser Trabeculoplasty) [7][9] - **Patient Compliance**: The company recognizes the challenges of patient compliance with traditional treatments like eye drops, advocating for more effective interventional methods [6][9] Performance Metrics - **Q2 Performance**: Surgical glaucoma revenue was down mid-single digits, significantly better than the anticipated 15% decline due to MIGS restrictions. The company reported a 12% sequential increase in utilization [10][11] - **Surgeon Engagement**: The company has seen record numbers of ordering accounts, indicating strong engagement with its commercial team [10][11] Regulatory and Payer Dynamics - **Payer Scrutiny**: The rapid growth of the MIGS segment has led to increased scrutiny from payers, necessitating robust clinical evidence to support reimbursement [14][15] - **Clinical Evidence**: The company is focused on generating compelling clinical evidence to demonstrate the efficacy of its products, particularly the OMNI platform [16][50] OMNI Platform Innovations - **OMNI Edge**: The latest iteration of the OMNI platform, which enhances the volume of viscoelastic delivered during procedures, has received positive feedback from surgeons [17][18] - **Competitive Landscape**: The company believes it is ahead of competitors in technology and usability, which are critical factors for success in the market [20][21] Dry Eye Treatment Insights - **TearCare Development**: The company has developed TearCare to address the root causes of dry eye disease, focusing on meibomian gland dysfunction rather than tear insufficiency [25][28] - **Clinical Trials**: TearCare has completed two randomized controlled trials (RCTs) demonstrating its superiority over standard care, which is crucial for gaining reimbursement [29][50] - **Market Potential**: There are over 19 million diagnosed and an additional 19 million undiagnosed patients with dry eye disease in the U.S., indicating a significant market opportunity [43] Reimbursement Strategy - **Payer Engagement**: The company is actively engaging with payers to secure reimbursement for TearCare, leveraging strong clinical evidence and economic analyses [30][50] - **Future Goals**: The company aims for policy wins by 2025, with ongoing discussions and positive feedback from payers regarding the Sahara RCT [51][55] Conclusion - **Overall Outlook**: Sight Sciences is well-positioned in the interventional glaucoma and dry eye markets, with a strong focus on innovation, clinical evidence, and strategic payer engagement to drive future growth [4][50]

Financial Data and Key Metrics Changes - In Q4 2024, total revenue was $19.1 million, reflecting a 2% increase compared to the same period in the prior year [10][36] - Surgical glaucoma revenue for Q4 2024 was $18.8 million, up 9% year-over-year, driven by a 7% increase in ordering accounts and a 6% increase in account utilization [37][16] - Dry eye revenue for Q4 2024 was $0.3 million, a decrease from $1.6 million in the same period last year, primarily due to fewer SmartLid sales [38][36] - Gross margin for Q4 was 87%, an increase from 85% in the prior year, mainly due to an improved surgical glaucoma product mix [39] - The net loss for Q4 was $11.8 million, or $0.23 per share, compared to a net loss of $10.7 million, or $0.22 per share for Q4 2023 [39] Business Line Data and Key Metrics Changes - Surgical glaucoma revenue grew 9% year-over-year, despite headwinds from new Medicare LCDs [16][37] - The number of customers ordering surgical glaucoma products increased by 3% sequentially and 7% year-over-year [38] - The dry eye segment is focused on achieving reimbursed market access, with a significant decline in revenue due to strategic shifts [36][25] Market Data and Key Metrics Changes - The MIGS market has faced challenges due to new Medicare LCDs, impacting the ability to bill for multiple MIGS procedures [17][19] - Despite short-term declines in MIGS utilization, the company anticipates long-term growth driven by increasing patient demand for glaucoma treatment [19][42] - The company estimates over 13 million U.S. patients are diagnosed with Meibomian gland disease, indicating a significant market opportunity for TearCare [25] Company Strategy and Development Direction - The company aims to build commercial momentum in MIGS and establish equitable reimbursement for TearCare, focusing on customer education and engagement [13][34] - Plans for 2025 include launching the next-generation Omni Edge and continuing to develop the Pseudophakic standalone market [21][45] - The company is committed to addressing the unmet needs in glaucoma and dry eye markets through innovative interventional technologies [11][32] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in achieving cash flow break-even without raising additional equity capital [35] - The company expects 2025 to be transformational, anticipating positive coverage decisions for TearCare [14][41] - Management acknowledged the impact of tariffs on gross margins and operational results, while planning to mitigate these costs through various adjustments [44][45] Other Important Information - The company ended Q4 with $120.4 million in cash and cash equivalents and $40 million in debt [40] - The company has not yet received monetary damages from a patent infringement case against Alcon, with the final ruling pending [41] Q&A Session Summary Question: How is market development on the standalone MIGS market going? - Management noted good momentum in capturing broader adoption of interventional mindset in glaucoma care, with ongoing education efforts [48][51] Question: Can you provide updates on TearCare reimbursement claims? - Management reported increasing volume of claims with some early traction from specific payers, but standardization is still lacking [58][61] Question: What are the trends in surgical glaucoma since the new LCDs? - Management indicated that trends are tracking as expected, with good engagement from customers on where OMNI fits into treatment paradigms [66][70] Question: How is the competitive landscape affecting OMNI volumes? - Management expressed confidence in OMNI's strong market position despite new entrants, emphasizing the importance of clinical evidence and usability [115][117]