Great. Good afternoon, everyone. Thomas Stephan with Stifel. Really excited to have Sight Sciences here with us today. Ali, Jim, Paul, great to see you all. Have about 25 minutes, so I'm going to jump right into Q&A and kick things off on the MIGS side, and then we'll finish on the dry eye side. Thinking about performance over the last several quarters, surgical glaucoma, now interventional glaucoma, has grown mid to high single digits, I think, for three straight quarters now. Team, maybe if you can kick things off, just talking about the drivers of the recent momentum in that business, and then I'll have some follow-ups. Yeah. Tom, I'll start off, and Jim, if you want to add. I emphasize the growing mindset in interventional glaucoma. We've spent years educating the market on the benefits of intervening earlier for glaucoma patients. Serious disease, world's leading cause of irreversible blindness, the data is pretty clear. Intervening earlier leads to better long-term outcomes. With years of education from Sight Sciences and from other industry players, I think it's becoming more and more clear, Tom, and I think you've seen that at conferences recently, this growing mindset and moving beyond the mindset to activation. Moving beyond an understanding that intervening earlier is better to actually doing it. That's, I'd say, the market or sector's tailwind. As it relates to Sight specifically, look, I'd say for years, we have been laser-focused on MIGS and driving interventional glaucoma. We have a very tenured team in the MIGS space. We have continued focus. I think a lot of the other industry participants have lost some of that focus, and we remain laser-focused. Moving beyond the LCDs, in a one MIGS world, I think our product, our technology, our clinical outcomes from OMNI are proven. We've proven that OMNI delivers durable, long-term, reliable, and consistent clinical outcomes. That leads to a very sticky business with our customers. Our active accounts have been at or near all-time highs for the past couple of quarters. We've had stable pricing. We're the market leader in implant-free MIGS, and we're continuing to focus on the category. Lastly, and arguably most importantly, driving the activation of the standalone market. We have a dedicated team, six people that are focused on activating pseudophakic standalone. We have a very interesting playbook for helping accounts convert from interventional mindset to interventional activation. Early results are very encouraging, and we're looking to scaling that up going forward. Jim, anything to add? I think that covers it. Yeah. That's a good bit about where we're at on MIGS. No, it's fantastic. Great foundation to set there, Paul. Wanted to ask about kind of U.S. end market growth. We've now kind of lapped the MIGS LCD impact. Based on what you've seen this year and your expectations moving forward for the rest of the year, what do you guys view as sort of the MIGS market growth rate in 2026? Maybe if you can just talk about your overall view of U.S. MIGS market health. We're happy, Tom, to finally be moving past the LCDs. The market is more stable. It's back to growth. We'd estimate it's low to mid-single-digit growth. That being said, there is this important tailwind that's interventional glaucoma and interventional glaucoma activation. IG is here to stay. This is a serious disease, world's leading cause of irreversible blindness, we're really in the early innings of transforming care. Historically, even today, the standard of care remains eye drops, daily topical eye drops, being on multiple regimens. Maybe doing MIGS in between, maybe doing more laser or more MIGS, ultimately moving to invasive alternatives. It's been shown that intervening either with SLT or with MIGS earlier is better for patients long term. By far, the standard of care remains daily topical eye drops. We think it's a healthy market. It's here to stay. Interventional glaucoma will be growing in the years to come. Got it. That's great. Maybe digging into the share side of the equation a little bit. The competitive landscape in MIGS, it's always evolving. You had the MIGS LCDs creating kind of a single MIGS environment. iDose is performing well. Hydrus maybe is having some challenges. You have iTrack ramping, some new canaloplasty competition as well. Paul, maybe to stick with you, just discuss your view of OMNI share and OMNI share gains and what your level of confidence is that OMNI can kind of continue its cadence of share gains moving forward. Sure, Tom. Yeah, to start off, we're the leader in implant-free MIGS. I think we're the number two player in MIGS overall, with trabecular bypass stenting being market share leader. Again, we lead in implant-free MIGS. Look, when we launched OMNI many years ago, it was already a competitive market. That hasn't calmed down at all. It's a big problem. It's a big disease, and patients need lots of innovation, and industry continues to innovate. We've seen lots of competition. We've competed effectively over the years. We continue to compete very effectively. Going forward, continue to take share in combo cataract, expand the combo cataract market, drive activation and market development of the standalone market. There's so much opportunity behind this interventional glaucoma tailwind. Yeah, we have to be competitive, and we have been, and we continue to be. I think we've got a dedicated, tenured, MIGS-focused team. A very good MIGS team. We have very good technology, and we continue to innovate. We've talked about having another generation of the OMNI platform, hopefully arriving later this year. This is, we're many generations in. I think the next one, OMNI Ultra, is going to have another leap in technology. We're continuing with our focus, with our investments, with pioneering market development, continuing to perfect, iterate, and improve our technology on behalf of the customers we serve and the patients that they serve. We think that we have still a lot of runway ahead of us. We expect to continue to be the leader in implant-free MIGS moving forward. Hopefully, we close the gap on our overall position in the market over time. Yeah, that's great. OMNI Ultra, you mentioned that, Paul. Maybe if you can, if you're able to elaborate a bit on what that leap is relative to the existing generation of OMNI. What kind of is that key point of differentiation? Sure. A number of advancements in OMNI Ultra that we're looking forward to getting into our customers' hands. First, catheter travel. Single incision, single entry point in the cornea, but allowing the surgeon to circumnavigate the entire circumference of the canal with one advancement, not two. Right now, we have two. We break it up into two steps, our current OMNI. The next one will be 360 in one shot. Another really important feature will be using our TruSync Technology, which is proprietary. It's automated, controlled, predictable, reliable delivery of a fixed volume of viscoelastic automatically. That surgeon doesn't need to think. You're not going to get variable results. You're not going to have a variable procedure and outcomes. Leveraging our TruSync Technology, we will automatically deliver a fixed volume of viscoelastic on catheter advancement, and we think that there's a number of benefits in doing that. Another fixed higher volume of viscodilation upon catheter retraction. Automated deployment of viscoelastic on advancement and retraction, which offers, we believe, some surgical advantages there. We have markings on the catheter to allow the surgeon to understand how much of the procedure they've completed. One quadrant, two quadrants, three quadrants. They'll get a marking on the catheter telling them how far they've traveled. That's a desired feature that our surgeons have asked us for. Lastly, the handle itself, the ergonomics. It's a shorter handle, easier to hold, and has some advantages on certain kinds of microscopes in the operating room. We listen to our customers always. We're out there, like I said, we have one of the most focused MIGS teams in the business. We listen closely to our customers, and I think we've taken a lot of their requests on how to make OMNI better, and we're delivering it back to them. Got it. Super helpful. Thanks for that, Paul. Sure. Maybe to zero in a little more near term on the second quarter. I believe you guys guided to mid-single-digit percent year-over-year growth in glaucoma. That'd be a bit of a step down from 1Q 2026 year-over-year growth in the high single-digit range, despite each quarter having a similar year-ago comp. I would say in 1Q, you kind of had a unique headwind from a weather standpoint. I guess, maybe Ali or Jim, to pull you in, are there any considerations we should be cognizant of in the second quarter that would drive a decel in the glaucoma business? Or do we maybe view the mid-single-digit% growth guide as more of your typical conservative approach to numbers, especially still being early in the year? Yeah. Thanks, Tom. I can take that one. We're really pleased with how we closed out Q1. We had a really strong March after, frankly, a little bit softer than expected January and February. That March performance brings along with it really good momentum, and we expect that momentum to continue into Q2 and the balance of the year. No, I wouldn't say there's anything in Q2 to highlight other than it being earlier in the year. We'll continue to evaluate as we go throughout the year, but leaving Q1 feeling really good about the performance and the momentum in that business. Fantastic. Super helpful. Thanks for that, Jim. Paul, maybe to flip back to you for my last question on the glaucoma side. Standalone, you mentioned in some of your earlier remarks, company taking, I'd say maybe for now, a more targeted approach. You're establishing that playbook. When does that maybe start to flow through to results in a more meaningful way, potentially? Where do we stand today in how that standalone strategy is deployed, and then at what point do you lean further into it and we can start to maybe see it drive some top-line benefit? Yeah. Thanks, Tom. I'd say last year we were laser-focused on perfecting the playbook, how to make it happen, how to activate accounts. They're bought in. They understand intervening earlier is better. They want to be more interventional, but how do they do it? They're busy practices, changing practice patterns, getting staff on board. It's an entire ecosystem in the office where these patients are being seen. Last year arrived at a prescriptive playbook that models the activation of interventional glaucoma closely after the activation of cataract surgery. That's tried and true. Every busy practice in America understands ophthalmic practice. Optometric practice understands how to advance patients who have cataracts to surgery. It's the number one procedure by volume in all of medicine. It's a great procedure. The ecosystem that supports getting those patients in the operating room is very mature. It kind of sounds obvious in hindsight, but arrived at why don't we model it after cataract surgery? What's different about that kind of flow is when the patient comes in for their typical appointment and they learn that they have cataracts, you then schedule a separate follow-up appointment, a cataract evaluation appointment, where you walk the patient through all of their options and arrive at a surgical plan. That has a much higher conversion rate than squeezing it into a typical appointment. We've done that with IG, where patient comes in, they're on two drops, will typically get a third drop, but then instead, you don't just say, "Hey, by the way, if I intervene, it's better. Should we go to the operating room?" That doesn't convert very effectively. If we have our customers bring those, and their staff and admin, everyone's educated to bring the patient back for an IG-specific consultation where you walk them through all of the options and you say, "Any of these things could be better for you than me writing a third script. Does that always result in conversion to OMNI? No. We're helping drive interventional glaucoma generally. That's what a market leader does. It's better for patients. It's better for doctors who take care of those patients. Will we get significant uplift and are we seeing significant uplift in those accounts that we do activate? Indeed we are. That was last year, the playbook, we love it. We're investing in it now. Like I said, we have half a dozen market development managers who are focused on standalone glaucoma. We are seeing good results from them. Again, it's a team of six. In terms of revenue uplift, just to get to your question, we're seeing results. We're seeing case volume. We're seeing revenue. When does it start to scale? Well, we'll need to scale it, right? We would think that this is a prove it out with the metrics, prove out acceleration, case volume growth, revenue growth with these six folks, and then begin to scale it up. I'd say, Thomas Stephan, in 2027, we would expect to start putting some scale on it. Got it. That's great. Thanks for that, Paul. Maybe to pivot to dry eye in sort of the last 10, 15 minutes or so. I'll start kind of more near-term questions, maybe even backward-looking. Novitas and First Coast, those from a reimbursement and fee schedule standpoint have been, call it live for six plus months now. Ali, maybe for you, how would you say the performance and the ramp-up in those regions has compared to your expectations so far? I know it's early, but maybe if you can just talk about Novitas and First Coast, the ramp-up there. Yeah. Thanks, Tom. I mean, first of all, we're really proud of the performance that we've had in the first couple quarters of post those fee schedules being established. We still are both working directly with the customers, getting their workflows established, growing our infrastructure here. We are primarily focused on five of those 13 states in First Coast, Novitas regions. Those are the areas where, of course, we're seeing the most success is the areas where we have dedicated resources, as you would expect, Texas, Florida, New Jersey, Pennsylvania, Maryland. Those are kind of the key areas where we have resources. Delivering $1.4 million in Q1 sales, that was certainly ahead of consensus and our guidance for the quarter. We saw in the quarter really strong performance. Accounts were growing their utilization off of those Q4 as they were proving out could they bill these and get paid? We have seen very consistent payment there. We've also seen new accounts coming on at higher levels than they did in the fourth quarter. We are really proud of that. We're seeing those reorders coming in. About half of those accounts are coming from our existing glaucoma customer base. That's also a really great synergy we're seeing in the business, is that there is these accounts that already are working with us on OMNI that have this higher level of traditional Medicare fee-for-service in their business. We feel really good about what we've been able to prove in a short period of time. This is just the beginning for us, for TearCare. There's a lot of opportunity for us to continue to take share. This is now within those areas, it's about 1/3 of the traditional Medicare. Medicare is about 15% of the total market for traditional Medicare. We're at 5% or so serviceable market right now. The level of utilization that we're seeing just with that limited market access is still quite compelling, and we expect that to continue to grow. Got it. Super helpful, Ali. You mentioned utilization. Good segue into my next question. Sticking with Novitas and First Coast, if we were to sort of isolate the accounts in those, call it focus states, the five focus states that were previous TearCare users. I know there's a mixture of existing versus kind of new customer contribution here. If we maybe compare to these same customers' prior peak volume run rates, so back to probably 2023 or 2024. Yeah. On average, how do those customers' utilization today compare to their prior peaks? Curious if you're seeing reimbursement already start to vault those legacy customers' volumes above their previous highs. Hopefully that question made sense. Yeah, definitely. What I would say, first of all, is that the target customers that we're buying in 2023 are very different than the ones buying today. There isn't as much overlap as you would originally expect, and that was one of our learnings in the first few months, is that those kind of cash pay, optometric-focused accounts are not necessarily the ones that are most comfortable billing traditional Medicare fee-for-service. A lot of those accounts are still dormant and waiting for us to get broader commercial coverage, and that really is more their interest than necessarily the traditional Medicare patients. For those accounts that are kind of crossover between that, it is significantly higher volume. Before it was very anecdotal doing a handful of cash pay procedures and a quarter, and now of course, you're seeing the utilization going up to the average was 16. Of course, there are many accounts that are doing multiples of that, which is great to see as well. We'll still have to see how that utilization changes over time as we get a broader density of coverage in- Right A specific area. The trends are extremely encouraging and just in general, the willingness to do a procedure when it is with reimbursement through their primary insurance instead of having to pay out of pocket. That market is many multiples size of each other. It's not surprising that we would see a higher utilization in that. Got it. That's great. Last one here, again, more sort of near term. On the 1Q call, I think you mentioned potential payer wins by the end of the year. Additional fee schedules being established. Can you discuss kind of just your visibility into additional wins here looking forward? Are there any late-stage conversations in place, or what kind of gives you the confidence we could see something over the next six, seven months? Yeah. First of all, I would say, of course, any engagement with payers are always subject to some level of uncertainty and unpredictability. We do feel like we are having productive conversations with the MACs, and really the stage we're at with multiple MACs is showing demand for the procedure and showing them that there is enough demand that they should establish a fee schedule, and then they can do the work to establish the fee schedule. Do think that we've provided good baseline support for the clinical value and the need for this, and now it's really on our KOLs to demand that these fee schedules are necessary based on the beneficiaries in those states. Got it. That's great. Maybe digging into the numbers a little bit. For 2026 revenue on the dry eye side, I think guidance is for $7 million at the midpoint. 2Q around $1.7 million-$1.8 million at the midpoint, which would imply in the second half only about $2 million per quarter. From 4Q 2025 to 1Q 2026, you almost doubled. Are there any reasons revenues on the dry eye side would flatten out a bit throughout the year? Alternatively, talk about kind of your level of confidence and upside to that $7 million midpoint of the dry eye guide. Yeah, Tom, I can take that one. Ali, you can chime in as needed as well. Like Ali said, we feel really good about the first quarter performance, the traction we've had in this business, doubling from Q4 to Q1. Of course, Q4 wasn't really a full quarter. We got that market access near the tail end of October. We added some resources throughout the end of Q4 and into Q1, but we feel really good about how the year sets up. You saw that with our increase to guidance of $1 million here coming off of the Q1 call. We expect this business to continue to scale, but we're in the very, very early innings of this. Want to see that momentum continue, and we really feel good about where we set the guidance. We feel confident in it, and we expect to go continue to scale this business. Got it. Jim, for 2026 total revenue guidance, as you mentioned on the 1Q print, you raised in dry eye, but maintained in glaucoma. Do we view dry eye as maybe the potential bigger upside driver to revenue this year? Or do you believe each business between glaucoma and dry eye maybe has the same level of conservatism based into the outlook? Just curious where investors should be thinking about where there might be some more cushion to drive upside to consensus. Sure, Tom, thanks. You know our philosophy on guidance, setting achievable guidance that we're confident we can go deliver, and we feel like we've set a disciplined guide here for the year. Again, on glaucoma, feeling really good about how we came out of Q1. Early in the year, want to be disciplined and see that play out. For the full business, full year, really excited to be back to double-digit growth and delivering on that double-digit growth for the year. In our dry eye guide, we did not assume additional market access wins. To the extent those come sooner or here in 2026, that could definitely be some upside. Overall, feeling good about getting back to double-digit growth and feel confident about where we set the guide. Perfect. That's great. Thanks for that, Jim. Last question, we have about maybe a minute or two. Going back to TearCare, wanted to ask on peak sales. Any refined thinking on what that peak sales number in the U.S. could look like? Our work has led to sort of a $100 million number as an achievable figure based on around 100,000 patients or so per year. Is that reasonable? Could that be conservative? Curious your reaction. Ali, maybe- Yeah Just quick thoughts before we wrap. Yeah. From my perspective, there are over seven million moderate to severe MGD patients in the U.S., so 100,000 patients would be a penetration of 1%-2% of those patients. That would be very small versus what we think we can do. Now, of course, this takes execution, market access, expansion, investments, all of those things. From our perspective, TearCare is a unique asset because it provides value to everyone. It provides value to the patients as a better procedural intervention versus daily eye drops, provides benefit to the ECP who gets to participate in the economics, and also provides value to the payer because it's less expensive than other dry eye treatments. If all of those things combined only leads to 1% - 2% penetration in something that would be recurring in nature for most patients where they're getting annual treatments, that would be a disappointing result from our perspective versus opportunity. Got it. Tom, I would just add to that maybe to rethink the opportunity. If you go back well over a decade when we started the development of TearCare, we saw a need really to create a category. Dry eyes, if it's not number one, it's one of the top three reasons for a visit to an eye care provider. Sure. There are no reimbursed treatments that address the root underlying cause of disease. Yeah. As Ali mentioned, we built the business. We designed the technology, the business model, the SAHARA RCT. We built this in a manner that would allow us to actually create this category of interventional dry eye. The way that you can create a category like this, where there's so many patients suffering from this disease, it's a heavy lift, but you have to bring something to market that offers value to every stakeholder. Value to the patient, value to the provider. Right Value to the payer, value to all of the stakeholders. We've done that. When you think of it that way, creation of a significant new category in eye care, I think it's one of the more interesting opportunities today in ophthalmology. Awesome note to end on. Team, thanks so much for participating. Really appreciate it. Thank you. Thanks, Tom. We got it. Thanks. Thanks.