Company Overview
Sight Sciences, Inc. is an eye care technology company dedicated to developing and commercializing innovative, interventional technologies that aim to transform the standard of care for patients suffering from prevalent eye diseases. Founded in 2010 and headquartered in Menlo Park, California, Sight Sciences has established itself as a leader in the medical device industry by addressing significant unmet needs in the glaucoma and dry eye markets.
The company was co-founded by Paul Badawi and David Badawi, M.D. with the mission of developing transformative, interventional technologies that allow eye care providers to procedurally elevate the standards of care, empowering people to keep seeing. Sight Sciences' initial product development efforts focused on the treatment of two of the world's most prevalent and underserved eye diseases - glaucoma and dry eye disease. In 2015, the company began selling its first commercial products, VISCO360 and TRAB360, which were the commercial predicate devices to its current flagship product, the OMNI Surgical System.
Product Portfolio
The company's product portfolio is aligned with its two reportable operating segments: Surgical Glaucoma and Dry Eye. In the Surgical Glaucoma segment, Sight Sciences offers the OMNI Surgical System (OMNI) and the SION Surgical Instrument (SION). OMNI is an implant-free, handheld, single-use, therapeutic technology that enables ophthalmic surgeons to perform a comprehensive procedure to reduce intraocular pressure (IOP) in adult patients with primary open-angle glaucoma (POAG). SION is a bladeless, manually operated device used in ophthalmic surgical procedures to excise trabecular meshwork. In the Dry Eye segment, the company's flagship product is the TearCare System (TearCare), a proprietary, interventional device designed to melt and facilitate the comprehensive removal of meibomian gland obstructions and restore gland functionality and healthy oil production for adult patients with evaporative dry eye disease due to meibomian gland dysfunction (MGD).
Mission and Business Philosophy
Sight Sciences' mission is to develop transformative, interventional technologies that allow eye care providers to procedurally elevate the standards of care, empowering people to keep seeing. The company's business philosophy is grounded in comprehensively understanding disease physiology, developing transformative technologies that preserve, protect, and restore natural physiological functionality to diseased eyes, and providing intuitive, patient-friendly, interventional solutions to ophthalmologists and optometrists.
Financial Performance
Sight Sciences has experienced significant growth since its inception, driven by the strong adoption of its innovative products. For the full year ended December 31, 2024, the company reported total revenue of $79.9 million, a slight decrease of 1% compared to the prior year. This performance was primarily attributable to a 2% increase in Surgical Glaucoma revenue, offset by a decline in Dry Eye revenue as the company focused on establishing reimbursement coverage for the TearCare procedure.
The company's Surgical Glaucoma segment, which includes the OMNI and SION products, accounted for 95% of total revenue in 2024, generating $75.9 million. OMNI, the flagship product in this segment, has demonstrated compelling clinical outcomes, with a recent real-world study published in 2025 showcasing sustained intraocular pressure reductions and decreased medication dependence over a 36-month period in patients with POAG. This data further solidifies OMNI's position as a market-leading choice for surgeons seeking to comprehensively address all three known areas of resistance in the conventional outflow pathway.
In the Dry Eye segment, Sight Sciences has made significant strides in its efforts to establish equitable reimbursement coverage for the TearCare procedure. The company's robust clinical data, including positive results from the landmark SAHARA randomized controlled trial and a recently published budget impact analysis, have created a compelling case for payers to provide coverage and appropriate reimbursement levels for this innovative treatment. While the Dry Eye segment represented only 5% of total revenue in 2024, generating $4 million, the company believes this market presents a substantial long-term opportunity, with an estimated 13 million U.S. patients diagnosed with MGD, the leading cause of dry eye disease.
Financials and Liquidity
Sight Sciences' financial position remains strong, with $120.4 million in cash and cash equivalents and $40 million in debt as of December 31, 2024. The company has demonstrated disciplined expense management, with a 62% reduction in net cash used for operations in 2024 compared to the prior year. This financial stability allows Sight Sciences to continue investing in its strategic initiatives, including building commercial momentum in the MIGS market, establishing equitable reimbursement for TearCare, and advancing its robust pipeline of interventional technologies.
For the full year 2024, Sight Sciences reported a net loss of $51.5 million and negative operating cash flow of $22.4 million. The company's annual free cash flow stood at -$22.7 million. Despite these losses, Sight Sciences maintains a strong liquidity position with a debt-to-equity ratio of 0.46, a current ratio of 9.04, and a quick ratio of 8.63 as of December 31, 2024. The company also has access to a $65 million credit facility with Hercules Capital, of which $40 million was drawn as of the end of 2024, with the remaining $25 million available subject to the achievement of certain milestones.
In the most recent quarter (Q4 2024), Sight Sciences reported revenue of $19.1 million, representing a 2% increase year-over-year. This growth was primarily driven by a 9% increase in surgical glaucoma revenue, which reached $18.8 million. However, the company experienced a decline in dry eye revenue, which decreased to $0.3 million from $1.6 million in the same period the previous year, reflecting the company's shift in focus towards establishing reimbursement coverage for TearCare.
Geographic Markets and Industry Trends
Sight Sciences primarily sells its products in the United States, with approximately 95% of its total revenue generated from U.S. customers. This focus on the domestic market aligns with the company's strategy to establish strong market positions in its core segments before expanding internationally.
The company operates in rapidly growing markets. The global glaucoma devices market is expected to grow at a compound annual growth rate (CAGR) of approximately 6% from 2022 to 2030, driven by the increasing prevalence of glaucoma and the growing adoption of minimally invasive glaucoma surgery (MIGS) devices. Similarly, the dry eye disease treatment market is projected to grow at a CAGR of approximately 5% from 2022 to 2030, fueled by the rising prevalence of dry eye disease and the development of new, more effective treatment options.
Future Outlook and Guidance
Looking ahead, Sight Sciences has initiated full-year 2025 revenue guidance of $70 million to $75 million. This range reflects the anticipated impact of new Medicare Local Coverage Determinations (LCDs) that restrict coverage for certain MIGS procedures performed in combination with cataract surgery. The company estimates that these changes will reduce total MIGS claims by about 15% or 50,000 procedures in 2025.
For the first quarter of 2025, Sight Sciences expects revenue to be down low to mid-double digits compared to the prior year, reflecting the full quarter impact of the multiple MIGS procedure restrictions. Despite these near-term challenges, the company remains focused on maximizing the utilization of OMNI, particularly in the Pseudophakic standalone patient segment, and on achieving positive reimbursement coverage decisions for TearCare.
Sight Sciences has also provided guidance for its 2025 adjusted operating expenses, projecting a range of $105 million to $107 million. This represents a 4-6% increase compared to 2024 and includes investments in the Pseudophakic standalone surgical glaucoma market, TearCare market access, and increased research and development efforts.
Importantly, the company believes it is properly funded to reach cash flow break-even without the need for additional equity capital, underlining its financial stability and strategic planning.
Challenges and Progress
Over the years, Sight Sciences has faced several challenges in the commercialization of its products. In 2023, the company was impacted by proposed local coverage determinations from Medicare Administrative Contractors that would have rendered canaloplasty, a procedure associated with the OMNI Surgical System, as investigational and non-covered. While these proposed determinations were ultimately withdrawn, the final local coverage determinations that became effective in 2024 included restrictions on performing multiple MIGS procedures at the same time as cataract surgery, which has had an adverse impact on the company's surgical glaucoma business. Additionally, the company has faced challenges in achieving reimbursement coverage for its TearCare System, which has historically been sold on a cash-pay basis as the company works to establish appropriate and equitable reimbursement.
Despite these challenges, Sight Sciences has continued to make progress in the development and commercialization of its innovative technologies. As of December 31, 2024, the company has an estimated 295,000 uses of its surgical glaucoma products in over 2,100 hospitals and ambulatory surgery centers in the U.S. and Europe, and over 65,000 estimated uses of its TearCare technology in over 1,500 eye care facilities in the U.S.
Sight Sciences' compelling product portfolio, robust clinical evidence, and strategic initiatives position the company as a leader in the eye care technology industry. As the company navigates the evolving market landscape, its dedication to innovation and its mission to transform the standard of care for patients suffering from prevalent eye diseases will be key drivers of its long-term success.