Sight Sciences (SGHT) 10-K 12 Mar 24 2023 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Mar. 05, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Period End Date	Dec. 31, 2023
Amendment Flag	false
Trading Symbol	SGHT
Entity Registrant Name	SIGHT SCIENCES, INC.
Entity Central Index Key	0001531177
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Shell Company	false
Entity Ex Transition Period	false
Document Fiscal Period Focus	FY
Entity Public Float			$ 301.8
Entity Common Stock, Shares Outstanding		49,553,371
ICFR Auditor Attestation Flag	false
Document Financial Statement Error Correction [Flag]	false
Entity File Number	001-40587
Entity Tax Identification Number	80-0625749
Entity Address, Address Line One	4040 Campbell Ave
Entity Address, Address Line Two	Suite 100
Entity Address, City or Town	Menlo Park
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	94025
City Area Code	877
Local Phone Number	266-1144
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, par value $0.001
Security Exchange Name	NASDAQ
Entity Incorporation, State or Country Code	DE
Document Annual Report	true
Document Transition Report	false
Documents Incorporated by Reference	Portions of the Registrant's definitive Proxy Statement relating to its 2024 Annual Meeting of Stockholders to be filed with the SEC within 120 days after the end of the fiscal year ended December 31, 2023 are incorporated herein by reference in Part III of this Annual Report on Form 10-K.
Auditor Name	DELOITTE & TOUCHE LLP
Auditor Location	San Jose, California
Auditor Firm ID	34

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 138,129	$ 185,000
Accounts receivable, net of allowance for credit losses of $1,024 and $1,186 at December 31, 2023 and 2022, respectively	14,289	15,148
Inventory, net	7,849	6,114
Prepaid expenses and other current assets	2,604	3,415
Total current assets	162,871	209,677
Property and equipment, net	1,640	1,571
Operating lease right-of-use assets	1,458	1,614
Other noncurrent assets	682	211
Total assets	166,651	213,073
Current liabilities:
Accounts payable	1,731	2,688
Accrued compensation	4,528	7,352
Accrued and other current liabilities	3,774	7,777
Current portion - long-term debt, net	2,219	0
Total current liabilities	12,252	17,817
Long-term debt, net of current portion	31,708	33,313
Other noncurrent liabilities	2,476	1,867
Total liabilities	46,436	52,997
Commitments and contingencies (Note 6)
Stockholders' equity:
Preferred stock par value of $0.001 per share; 10,000,000 authorized; no shares issued and outstanding as of December 31, 2023 and 2022, respectively	0	0
Common stock par value of $0.001 per share; 200,000,000 shares authorized as of December 31, 2023 and 2022, respectively; 49,131,363 and 48,298,138 shares issued and outstanding as of December 31, 2023 and 2022, respectively	49	48
Additional paid-in-capital	414,956	399,271
Accumulated deficit	(294,790)	(239,243)
Total stockholders' equity	120,215	160,076
Total liabilities and stockholders' equity	$ 166,651	$ 213,073

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Accounts Receivable, net of Allowance for Credit Losses	$ 1,186	$ 1,024
Preferred stock par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred Stock, Shares Issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	200,000,000	200,000,000
Common Stock Shares Issued	49,131,363	48,298,138
Common Stock Shares Outstanding	49,131,363	48,298,138

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Statement [Abstract]
Revenue	$ 81,056	$ 71,331
Cost of goods sold	11,881	12,361
Gross profit	69,175	58,970
Operating expenses:
Research and development	17,556	22,859
Selling, general and administrative	108,893	120,065
Total operating expenses	126,449	142,924
Loss from operations	(57,274)	(83,954)
Interest expense	(5,408)	(4,466)
Other income (expense), net	7,245	2,225
Loss before income taxes	(55,437)	(86,195)
Provision for income taxes	110	47
Net loss and comprehensive loss	$ (55,547)	$ (86,242)
Net loss per share attributable to common stockholders-basic	$ (1.14)	$ (1.8)
Net loss per share attributable to common stockholders-diluted	$ (1.14)	$ (1.8)
Weighted-average shares of common stock outstanding-basic	48,628,940	47,849,058
Weighted-average shares of common stock outstanding-diluted	48,628,940	47,849,058

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Retained Earnings
Beginning Balance, Amount at Dec. 31, 2021	$ 232,107	$ 48	$ 385,060	$ (153,001)
Beginning Balance, shares at Dec. 31, 2021		47,504,704
Issuance of common stock upon exercise of stock options (In Shares)		683,482
Issuance of common stock upon exercise of stock options	576		576
Issuance of common stock upon vesting of restricted stock units (In Shares)		11,028
Employee stock purchase plan purchases, Shares		98,924
Employee stock purchase plan purchases	672		672
Stock-based compensation expense	12,963		12,963
Net loss	(86,242)			(86,242)
Ending Balance, Amount at Dec. 31, 2022	160,076	$ 48	399,271	(239,243)
Ending Balance, Shares at Dec. 31, 2022		48,298,138
Issuance of common stock upon exercise of stock options (In Shares)		368,683
Issuance of common stock upon exercise of stock options	395		395
Issuance of common stock upon vesting of restricted stock units (In Shares)		243,665
Issuance of common stock upon vesting of restricted stock units	1	$ 1
Withholding taxes on net share settlement of restricted stock units	(224)		(224)
Employee stock purchase plan purchases, Shares		220,877
Employee stock purchase plan purchases	933		933
Stock-based compensation expense	14,581		14,581
Net loss	(55,547)			(55,547)
Ending Balance, Amount at Dec. 31, 2023	$ 120,215	$ 49	$ 414,956	$ (294,790)
Ending Balance, Shares at Dec. 31, 2023		49,131,363

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net loss	$ (55,547)	$ (86,242)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	614	710
Accretion of debt discount and amortization of debt issuance costs	614	657
Stock-based compensation expense	14,581	12,963
Provision for credit losses	198	402
Provision for excess and obsolete inventories	418	614
Noncash operating lease cost	1,006	542
Loss on disposal of property and equipment	66	85
Changes in operating assets and liabilities:
Accounts receivable	661	(6,841)
Inventory	(2,156)	(3,253)
Prepaid expenses and other current assets	812	751
Other noncurrent assets	(470)	(10)
Accounts payable	(883)	(694)
Accrued compensation	(2,823)	1,364
Accrued and other current liabilities	(4,605)	2,634
Other noncurrent liabilities	330	353
Net cash used in operating activities	(47,184)	(75,965)
Cash flows from investing activities:
Purchases of property and equipment	(791)	(970)
Net cash used in investing activities	(791)	(970)
Cash flows from financing activities:
Proceeds from exercise of common stock options	395	576
Taxes paid on net settlement of restricted stock units	(224)	0
Proceeds from employee stock purchase plan purchases	933	672
Net cash provided by financing activities	1,104	1,248
Net change in cash and cash equivalents	(46,871)	(75,687)
Cash and cash equivalents at beginning of period	185,000	260,687
Cash and cash equivalents at end of period	138,129	185,000
Supplemental disclosure of cash flow information
Cash paid for interest	4,267	3,252
Supplemental disclosure of non-cash investing and financing information
Acquisition of property and equipment included in accounts payable and accrued liabilities	$ 60	$ 103

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Pay vs Performance Disclosure
Net Income (Loss)	$ (55,547)	$ (86,242)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

The Company and Nature of Busin

The Company and Nature of Business	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Company and Nature of Business	Note 1. The Company and Nature of Business Description of Business Sight Sciences, Inc. (the “Company”) was incorporated in the State of Delaware in 2010 and is headquartered in Menlo Park, California. The Company is an ophthalmic medical device company focused on the development and commercialization of surgical and nonsurgical technologies for the treatment of prevalent eye diseases. The Company's product portfolio aligns with its two reportable operating segments: Surgical Glaucoma and Dry Eye. The products for the Surgical Glaucoma segment include the OMNI® Surgical System ("OMNI"), which is an implant-free glaucoma surgery technology indicated to reduce intraocular pressure in adult patients with primary open-angle glaucoma, the world's leading cause of irreversible blindness, and the SION® Surgical Instrument ("SION"), a manually operated device used in ophthalmic surgical procedures to excise trabecular meshwork. The product portfolio for the Dry Eye segment consists of the TearCare® System ("TearCare") for ophthalmologists and optometrists. TearCare is a wearable eyelid technology for adult patients with evaporative dry eye disease due to meibomian gland dysfunction (MGD) when used in conjunction with manual expression of the meibomian glands, enabling clearance of gland obstructions by physicians to address the leading cause of dry eye disease. Significant Risks and Uncertainties Since inception, the Company has incurred losses and negative cash flows from operations. As of December 31, 2023, the Company had an accumulated deficit of $ 294.8 million and recorded a net loss of $ 55.5 million for the year then ended and expects to incur additional losses in the future. If the Company’s revenue levels from its products are not sufficient or if the Company is unable to secure additional funding when desired, the Company may need to delay the development of its products, scale back its business and operations, or change its business strategy. The Company believes that its existing sources of liquidity will satisfy its working capital and capital requirements for at least 12 months from the issuance of its financial statements. Any failure to generate increased revenue, achieve improved gross margins, or control operating costs could require the Company to raise additional capital through equity or debt financing. Such additional financing may not be available on acceptable terms, or at all, and could require the Company to modify, delay, or abandon some of its planned future expansion or expenditures or reduce some of its ongoing operating costs, which could harm its business, operating results, financial condition, and ability to achieve its intended business objectives.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies Basis of Presentation The consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America ("US GAAP"). The Company’s consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries, Sight Sciences UK, Ltd and Sight Sciences GmbH. All intercompany balances and transactions have been eliminated in consolidation. Use of Estimates The preparation of financial statements in conformity with US GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent liabilities at the date of the financial statements, and the reported amounts of revenues and expense during the reporting period. The most significant estimates related to the provision for credit losses, inventory excess and obsolescence, the selection of useful lives of property and equipment, determination of the fair value of stock option grants, and provisions for income taxes and contingencies. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. These estimates are based on information available as of the date of the financial statements. Actual results could differ from these estimates and such differences could be material to the Company’s financial position and results of operations. Fair Value of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, and short-term and long-term debt. The Company's cash equivalents include U.S. treasury securities that are classified as held-to-maturity and recorded at amortized cost in the financial statements. The Company states accounts receivable, accounts payable, and accrued and other current liabilities at their carrying value, which approximates fair value due to the short time to the expected receipt or payment. The carrying amount of the Company’s short-term debt approximates its fair value as the effective interest rate approximates market rates currently available to the Company. Concentration of Credit Risk Financial instruments that subject the Company to concentration of credit risk consist of cash and cash equivalents and accounts receivable. The Company’s cash and cash equivalents are deposited with a high-quality financial institution. Deposits at this institution may, at times, exceed federally insured limits. Management believes that this financial institution is financially sound and, accordingly, that minimal credit risk exists. The Company has not experienced any losses on its deposits of cash and cash equivalents. The Company relies on third-party contract manufacturers for the manufacture of all of its commercial products currently available for sale, and also depends on a limited number of single source suppliers for some of the components, accessories, and materials used in the manufacture and assembly of its OMNI, TearCare and SION products, and any shortfall in the supply chain may cause its business to materially suffer. Disruption in production or its supply chain would have a negative impact on the Company’s financial position, results of operations and cash flows. For the years ended December 31, 2023 and 2022, there were no customers that represented 10 % or more of the Company's revenue. Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of 90 days or less, when purchased, to be cash and cash equivalents. As of December 31, 2023 and 2022, cash and cash equivalents includes $ 129.1 million and $ 144.3 million of U.S. treasury securities that are classified as held-to-maturity and recorded at amortized cost in the financial statements, respectively. As of December 31, 2023 and 2022, the remainder of cash and cash equivalents consists primarily of checking and savings deposits, which are recorded at cost, which approximate fair value. The Company’s cash balances exceed those that are federally insured. To date, the Company has not recognized any losses caused by uninsured balances. Accounts Receivable and Provision for Credit Losses Accounts receivable are stated at invoiced amounts, net of estimated provisions for credit losses. The Company’s provision for credit losses methodology for receivables is developed using its historical collection experience, current and future economic market conditions, and a review of the current aging status and financial condition of its customers. The Company uses its judgment, based on the best available facts and circumstances, and records a provision against amounts due to reduce the receivable to the amount that is expected to be collected. These specific provisions are reevaluated and adjusted as additional information is received that impacts the amount reserved. To date, the Company has not experienced material credit-related losses. The provision for credit losses was $ 1.2 million and $ 1.0 million as of December 31, 2023 and 2022, respectively. Inventory, net Inventory represents raw materials and finished goods purchased from third-party suppliers and manufacturers. Inventory is valued at the lower of cost or net realizable value. Cost is determined using actual costs on a first-in, first-out basis for all inventory. Net realizable value is determined as the estimated selling prices in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. As of December 31, 2023, the Company’s inventory balance consisted of finished goods of $ 7.3 million and raw materials of $ 1.0 million. As of December 31, 2022, the Company’s inventory consisted of finished goods of $ 5.8 million and raw materials of $ 0.4 million. The Company regularly reviews inventory quantities in consideration of actual loss experiences, projected future demand, and remaining shelf life to record a provision for excess and obsolete inventory when appropriate. The Company’s policy is to write down inventory that has become obsolete, inventory that has a cost basis in excess of its expected lower of cost or net realizable value, and inventory in excess of expected requirements. The estimate of excess quantities is judgmental and primarily dependent on the Company’s estimates of future demand for the particular product. As of December 31, 2023 and 2022, the Company has reserves for excess and obsolete inventory of $ 0.5 million and $ 0.1 million. Property and Equipment, net Property and equipment are recorded at cost, less accumulated depreciation. Repairs and maintenance costs are expensed as incurred. Depreciation is calculated using the straight-line method over the estimated useful lives of the assets, typically two to five years. When assets are retired or otherwise disposed of, the cost and accumulated depreciation are removed from the consolidated balance sheets and any resulting gain or loss is reflected in the consolidated statements of operations and consolidated loss in the period realized. Construction-in-process assets consist primarily of tools and equipment that have not yet been placed in service. These assets are stated at cost and are not depreciated. Once the assets are placed into service, assets are reclassified to the appropriate asset class based on their nature and depreciated in accordance with the useful lives above. Impairment of Long-Lived Assets The Company assesses long-lived assets, including property and equipment, whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. If indicators of impairment exist, an impairment loss may be recognized when estimated undiscounted future cash flows expected to result from the use of the assets and their eventual disposition are less than their carrying amount. Impairment, if any, is measured as the amount by which the carrying amount of the long-lived assets exceeds their fair value. Fair value is determined through various valuation techniques, including discounted cash flow models, quoted market values, and third-party independent appraisals, as considered necessary. The Company did no t record any impairment of long-lived assets for the years ended December 31, 2023 and 2022. Leases Contractual arrangements that meet the definition of a lease are classified as operating or finance leases and are recorded on the consolidated balance sheets as both a right-of-use asset (“ROU asset”) and lease liability, calculated by discounting fixed lease payments over the lease term at the Company’s incremental borrowing rate (“IBR”). Lease ROU assets and lease obligations are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. The Company currently does not have any finance leases. As the implicit rates for the Company's operating leases are not determinable, the Company uses an IBR based on the information available at the respective lease commencement dates to determine the present value of future payments. IBR represents the interest rate that the Company would expect to incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis with similar terms and payments, in an economic environment where the leased asset is located. The Company does not recognize lease ROU assets or lease liabilities for short-term leases, if any, having initial terms of 12 months or less at lease commencement as an accounting policy election, and recognizes rent expense on a straight-line basis over the lease term for these types of leases. Revenue Recognition The Company applies the following five steps in order to determine the appropriate amount of revenue to be recognized as it fulfills its obligations under each of its arrangements: • Identify the contract with a customer, • Identify the performance obligations in the contract, • Determine the transaction price, • Allocate the transaction price to performance obligations in the contract, and • Recognize revenue as the performance obligations are satisfied. Revenue recognized during the years ended December 31, 2023 and 2022 relates entirely to the sale of the Company’s products within the Surgical Glaucoma and Dry Eye segments. These sales are primarily to hospitals, medical centers, and eyecare professionals ("ECPs") throughout the United States. Sales are generally made through sales representatives and distributors. The Company’s revenue arrangements consist of a single performance obligation. Revenue is recognized at the point in time when control of the promised goods transfer to the Company’s customers. Revenue is measured at the amount of consideration expected to be received in exchange for the transfer of goods. The amount of revenue that is recognized is based on the transaction price, which represented the invoiced amounts and includes estimates of variable consideration, such as discounts, where applicable. The Company does not offer right of return, except in the case where items are defective as manufactured, and the company does not typically provide customers with a right to a refund. The amount of variable consideration included in the transaction price may be constrained and is included only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the contract will not occur in a future period. Payment terms, typically 30 days, are offered to customers and do not include a significant financing component. The Company extends credit to customers based upon their financial condition and credit history and generally require no collateral. The Company does not have any contract balances related to product sales. Shipping and handling costs incurred for the delivery of goods to customers are included in cost of goods sold. In cases where the Company bills shipping and handling cost to customers, the Company classifies those amounts in net revenue. As a practical expedient, the Company recognizes the incremental costs of obtaining contracts, such as sales commissions, as an expense when incurred since the amortization period of the asset we otherwise would have recognized is one year or less. Sales commissions are recorded within selling, general, and administrative expenses in the consolidated statements of operations and comprehensive loss. Cost of Goods Sold The Company purchases its components and products from third-party suppliers and manufacturers. Cost of goods sold consists primarily of costs related to materials, manufacturing overhead costs, reserves for excess, and obsolete and non-sellable inventories. Cost of goods sold also includes depreciation expense for production equipment and certain direct costs, such as shipping and handling costs. Research and Development The Company expenses research and development costs as incurred. Research and development expenses consist primarily of product development, clinical studies to develop and support the Company’s products, regulatory expenses, medical affairs, and other costs associated with products and technologies that are in development. Research and development expenses include employee compensation, including stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation, and an allocation of facility overhead expenses. Selling, General and Administrative Selling, general and administrative expenses include compensation, employee benefits, and stock-based compensation for executive management, commercial, finance administration, and human resources; facility costs (including rent); bad debt costs; professional service fees; and other general overhead costs, including depreciation to support the Company’s operations. Advertising Expense The Company expenses advertising costs as incurred. Advertising expenses for fiscal years 2023 and 2022 were $ 2.1 million and $ 2.6 million, respectively, included in selling, general, and administrative expenses in the consolidated statements of operations and comprehensive loss. Stock-Based Compensation The Company's equity incentive plan permits the grant of stock-based awards, such as stock options and restricted stock units ("RSUs"), to employees, directors and consultants. The Company’s employee stock purchase plan (“ESPP”) allows employees to purchase stock from the Company at a discount. The Company measures and records the expense related to stock-based payment awards based on the fair value of those awards as determined on the date of grant. The Company recognizes stock-based compensation expense over the requisite service period of the individual grant, generally equal to the vesting period and uses the straight- line method to recognize stock-based compensation, and accounts for forfeitures as they occur. The Company selected the Black-Scholes-Merton (“Black-Scholes”) option-pricing model as the method for determining the estimated fair value for stock options and the ESPP. The Black-Scholes option-pricing model requires the use of highly subjective and complex assumptions, which determine the fair value of share-based awards, including the option’s expected term, expected volatility of the underlying stock, risk-free interest rate and expected dividend yield. The fair value of RSU awards is determined based on the number of units granted and the closing price of the Company's common stock as of the grant date. Currency Remeasurement Foreign currency transaction gains and losses are recorded in other income (expense), net in the Company’s consolidated statements of operations and comprehensive loss. Such amounts have not been material for all periods presented. Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax bases of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. Management makes an assessment of the likelihood that the resulting deferred tax assets will be realized. A valuation allowance is provided when it is more likely than not that some portion or all off a deferred tax asset will not be realized. Due to the Company's historical operating performance and the recorded cumulative net losses in prior fiscal periods, the net deferred tax assets have been fully offset by a valuation allowance. The Company recognizes uncertain income tax positions at the largest amount that is more likely than not to be sustained upon audit by relevant taxing authority. An uncertain income tax position will not be recognized if it has less than a 50% likelihood of being sustained. Changes in recognition or measurement are reflected in the period in which judgment occurs. The Company's policy is to recognize interest and penalties related to the underpayment of income tax as a component of provision for income taxes. Comprehensive Loss Comprehensive loss represents all changes in stockholders’ equity except those resulting from distributions to stockholders. There have been no items qualifying as other comprehensive income (loss) and, therefore, for all periods presented, there was no difference between comprehensive loss and the Company’s reported net loss. Net Loss Per Share Attributable to Common Stockholders Basic and diluted net loss per share attributable to common stockholders is presented in conformity with the two-class method required for participating securities. Basic and diluted net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding for the period without consideration of potentially dilutive securities. The Company’s potentially dilutive shares, which consist of outstanding common stock options and restricted stock units, were excluded in the computation of diluted net loss per share for the period as the result would be anti-dilutive. Emerging Growth Company and Smaller Reporting Company The Company is an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012, as well as a "smaller reporting company, as defined by the Securities and Exchange Commission per Rule 12b-2 of the Exchange Act. As such the Company is eligible for exemptions from various reporting requirements applicable to other public companies that are not emerging growth companies or smaller reporting companies, including reduced reporting and extended transition periods to comply with new or revised accounting standards for public business entities. The Company has elected to avail themselves of this exemption and, therefore, will not be subject to the timeline for adopting new or revised accounting standards for public business entities that are not emerging growth companies, and will follow the transition guidance applicable to private companies. Recent Accounting Pronouncements Accounting Standards Adopted In June 2016, the Financial Accounting Standards Board (the "FASB") issued Accounting Standards Updated ("ASU") No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The ASU amends the impairment model by requiring entities to use a forward-looking approach based on expected losses to estimate credit losses on certain types of financial instruments, including trade receivables and available-for-sale debt securities. The guidance was effective for the Company beginning in the first quarter of 2023. The amendments in ASU 2016-13 were adopted with no material impact on the Company's consolidated financial statements. Accounting Standards Not Yet Adopted In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosure. The ASU updates reportable segment disclosure requirements, primarily through requiring enhanced disclosures about significant segment expenses and information used to assess segment performance. The ASU is effective for fiscal years beginning after December 15, 2023, with early adoption permitted. The Company is currently evaluating the impact of adopting this ASU on its disclosures. In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. The ASU includes amendments requiring enhanced income tax disclosures, primarily related to standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The guidance is effective for fiscal years beginning after December 15, 2024, with early adoption permitted, and should be applied either prospectively or retrospectively. The Company is currently evaluating the impact of adopting this ASU on its disclosures. As of December 31, 2023, there are no additional ASUs issued and not yet adopted that are expected to have a material impact on the Company's financial statements and related disclosures.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 3. Fair Value Measurements The Company reports all financial assets and liabilities and nonfinancial assets and liabilities that are recognized or disclosed at fair value in the financial statements on a recurring basis. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. The authoritative guidance establishes a fair value hierarchy that prioritizes the inputs to valuation techniques used to measure fair value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurements) and the lowest priority to measurements involving significant unobservable inputs (Level 3 measurements). The three levels of the fair value hierarchy are as follows: Level 1—Inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Inputs are unobservable inputs for the asset or liability. The level in the fair value hierarchy within which a fair value measurement in its entirety is based on the lowest-level input that is significant to the fair value measurement in its entirety. The Company's cash and cash equivalents included Level 1 investments in treasury securities of $ 129.1 and $ 144.3 million as of December 31, 2023 and 2022, respectively. These securities are classified as held-to-maturity and all have been purchased with original maturities of 90 days or less. Held-to-maturity debt securities are recorded at amortized cost in the financial statements. As of December 31, 2023 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. Treasury Securities $ 129,113 $ 28 $ — $ 129,141 As of December 31, 2022 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. Treasury Securities $ 144,319 $ 45 $ — $ 144,364 The Company measures the fair value of outstanding debt for disclosure purposes on a recurring basis. As of December 31, 2023 and 2022, total debt of $ 33.9 million and $ 33.3 million is reported at amortized cost, respectively. This outstanding debt is classified as Level 2 as it is not actively traded. The amortized cost of the outstanding debt approximates the fair value. The financial statements as of December 31, 2023 and 2022, do not include any assets or liabilities that are measured at fair value on a nonrecurring basis.

Balance Sheet Components

Balance Sheet Components	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Balance Sheet Components	Note 4. Balance Sheet Components Property and Equipment, Net Property and equipment, net consist of the following (in thousands): As of December 31, 2023 2022 Tools and equipment $ 2,010 $ 2,173 Computer equipment and software 37 37 Furniture and fixtures 323 282 Leasehold improvements 38 38 Construction in process 859 475 3,267 3,005 Less: Accumulated depreciation ( 1,627 ) ( 1,434 ) Property and equipment, net $ 1,640 $ 1,571 Depreciation expense was $ 0.6 million and $ 0.7 million for the years ended December 31, 2023 and 2022 respectively. Accrued and Other Current Liabilities Accrued and other current liabilities consist of the following (in thousands): As of December 31, 2023 2022 Accrued expenses $ 1,639 $ 5,307 Current portion of lease liabilities 573 1,033 Short term interest payable 375 348 Other accrued liabilities 1,187 1,087 Total accrued and other current liabilities $ 3,774 $ 7,775 Other Noncurrent Liabilities Other noncurrent liabilities consist of the following (in thousands): As of December 31, 2023 2022 Long term interest payable $ 1,524 $ 1,194 Noncurrent portion of lease liabilities 914 635 Other noncurrent liabilities 38 38 Total other noncurrent liabilities $ 2,476 $ 1,867

Debt

Debt	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Debt	Note 5. Debt In 2023, the Company had two credit and security agreements with certain entities affiliated with MidCap Financial Trust (such entities collectively, “MidCap”), which provided for a maximum $ 40.0 million credit facility, consisting of a $ 35.0 million senior secured term loan (the “MidCap Term Loan”) and a $ 5.0 million revolving loan (the "MidCap Revolver" and collectively with the Term Loan, the “MidCap Credit Facility”). In July 2023, the Company paid off and discharged all of its obligations under the agreement evidencing the MidCap Revolver, which terminated in accordance with the provision of the payoff and termination agreements. As of December 31, 2023, the MidCap Term Loan remained outstanding. As of December 31, 2023, commitment o bligations under the Amended and Restated Credit and Security Agreement (Term Loan) (the “MidCap Term Loan Agreement”) were guaranteed by the Company’s current and future subsidiaries, subject to exceptions for certain foreign subsidiaries, and secured by substantially all assets of the Company, including material intellectual property. Additionally, as of December 31, 2023, the Company was subject to customary affirmative and negative covenants as defined in the MidCap Term Loan Agreement, including minimum revenue and cash covenants, as well as covenants that limit or restrict the ability to, among other things, incur indebtedness, grant liens, merge or consolidate, make investments, dispose of assets, make acquisitions, pay dividends or make distributions, repurchase stock and enter into certain transactions with affiliates, in each case subject to certain exceptions. As of December 31, 2023, the Company was in compliance with all financial and non-financial covenants under the MidCap Term Loan Agreement. The MidCap Term Loan Agreement had a maturity date of November 1, 2025, and principal payments under the Term Loan were scheduled to commence in December 2024. As of December 31, 2023, the MidCap Term Loan Agreement contained events of default that included, among others, non-payment of principal, interest or fees, breach of covenants, inaccuracy of representations and warranties, cross-defaults and bankruptcy and insolvency events. In addition, as of December 31, 2023, the MidCap Term Loan Agreement included a stated floating interest rate that was reserve-adjusted Secured Overnight Finance Rate, plus 7.00 %, and a provision for a final payment fee of 6.0 % of the $ 35.0 million Term Loan balance, which had been partially accrued and recorded as a long-term interest payable in other noncurrent liabilities of $ 1.5 million as of December 31, 2023 and $ 1.2 million as of December 31, 2022. In January 2024, the Company entered into a loan and security agreement (the “Hercules Credit Agreement”) with Hercules Capital Inc. (“Hercules”) and certain of its affiliates (collectively with Hercules, the “Lenders”), which provides for a maximum $ 65.0 million credit facility. At closing, Hercules funded $ 35.0 million, which the Company utilized to pay in full the balance due under the MidCap Term Loan. The Hercules Credit Agreement has a maturity date of July 1, 2028 , with an interest only period of 30 months , which is extendable to up to 36 months . The stated floating interest rate under the Hercules Credit Agreement is the greater of 10.35 % or the Prime Rate plus 2.35 %, with the initial interest rate of 10.85 %. The final payment fee under the Hercules Credit Agreement is 5.95 % of the funded balance. Obligations under the agreement are subject to customary affirmative and negative covenants. In conjunction with the funding of the Hercules Credit Agreement, the Company issued warrants to the Lenders to purchase up to an aggregate of 135,686 shares of common stock at an exercise price of $ 5.159 per share, which have a term of seven years from date of issuance. Long-term and short-term debt, as of December 31, 2023 and 2022 was as follows (in thousands): As of December 31, 2023 2022 MidCap Term Loan $ 35,000 $ 35,000 Total principal payments due 35,000 35,000 Less: debt discount related to warrant liability and issuance costs ( 1,073 ) ( 1,687 ) Total amounts outstanding 33,927 33,313 Less: Current portion, net of discount ( 2,219 ) — Long-term debt $ 31,708 $ 33,313 The repayment schedule relating to the principal amount of the MidCap Term Loan as of December 31, 2023, is as follows (in thousands): Amount 2024 ( 2,917 ) 2025 ( 32,083 ) Thereafter — Total repayments $ ( 35,000 )

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 6. Commitments and Contingencies Operating Lease Obligations The Company’s leases include facility leases and storage leases. In determining the present value of lease payments, the Company uses its incremental borrowing rate based on the information available at the lease commencement date if the rate implicit in the lease is not readily determinable. The Company ’s incremental borrowing rate represents the interest rate that the Company would expect to incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis with similar terms and payments, in an economic environment where the leased asset is located. In determining the lease term, the Company includes all renewal options that are reasonably probable to be executed. The Company leases its corporate headquarters in Menlo Park, California. The lease commenced in August 2021 and was originally for a term of 37 months from the commencement date. In December 2023, the Company entered into an amendment to the lease, extending the lease term an additional 26 months. Upon signing the amendment, the Company recorded an aggregate lease right-of-use ("ROU") asset and lease liability of $ 1.2 million. The lease ROU asset and corresponding lease liability were estimated using a weighted-average incremental borrowing rate of 11.40 %. Total base rent for the remaining 34 months under the amended lease agreement is approximately $ 1.5 million. During the fourth quarter of 2022, the Company entered into a supply agreement that is expected to last approximately 18 months. The supply agreement contained provisions that, when evaluated, indicated an embedded lease was present within the agreement and the Company recorded an aggregate lease ROU asset and lease liability of $ 0.7 million. The lease ROU asset and corresponding lease liability were estimated using a weighted-average incremental borrowing rate of 10.75 %. Total base rent under the agreement is approximately $ 0.7 million. The Company recognizes rent expense on a straight-line basis over the noncancelable lease term. The Company’s rent expense was $ 1.2 million and $ 0.7 million for the years ended December 31, 2023 and 2022, respectively. As of December 31, 2023, the weighted average remaining lease term for the Company's leases was 2.5 years. Operating lease expense and supplemental cash flow information related to operating leases for the years ended December 31, 2023 and 2022 were as follows (in thousands): Years Ended December 31, 2023 2022 Operating lease expense $ 1,157 $ 732 Cash paid for operating leases 1,158 731 New operating lease assets obtained in exchange for 849 660 Aggregate future minimum lease payments at December 31, 2023 under these noncancelable operating leases was as follows (in thousands): As of December 31, 2023 2024 $ 700 2025 548 2026 468 Total future minimum lease payments $ 1,716 Less: imputed interest ( 229 ) Present value of future minimum lease payments $ 1,487 Less: current portion of operating lease liability ( 573 ) Operating lease liabilities - noncurrent $ 914 Legal Proceedings On September 16, 2021, the Company filed suit in the U.S. District Court for the District of Delaware (C.A. No. 1:21-cv-01317) alleging that Ivantis, Inc. directly and indirectly infringes U.S. Patent Nos. 8,287,482, 9,370,443, 9,486,361, and 10,314,742 by making, using, selling, and offering for sale the Hydrus® Microstent. The Company’s Complaint seeks money damages and injunctive relief. On January 24, 2022, Ivantis asserted counterclaims requesting declaratory judgments that the Company's asserted patents-in-suit are not infringed and/or invalid. On August 1, 2022, the Company filed an amended complaint alleging that Alcon Inc., Alcon Vision, LLC and Alcon Research, LLC infringe the four originally asserted patents by making, using, selling, and offering for sale the Hydrus® Microstent, and that all defendants also infringe U.S. Patent No. 11,389,328. The defendants reasserted counterclaims requesting declaratory judgments that the Company’s asserted patents-in-suit are not infringed and/or invalid. A five-day jury trial is scheduled to commence in the first half of April 2024. Ivantis and Alcon filed petitions with the U.S. Patent Office seeking inter partes review of U.S. Patent Nos. 8,287,482, 9,370,443, 9,486,361, and 10,314,742 (IPR2022-01529, IPR2022-01530, IPR2022-01533, IPR2022-01540), each of which the U.S. Patent Office denied for raising prior art references and invalidity arguments that were cumulative of those previously considered by the Office. The Company is presently unable to predict the outcome of this lawsuit or to reasonably estimate the potential financial impact of the lawsuit on the Company, if any. The Company is subject to claims and assessments from time to time in the ordinary course of business. Accruals for litigation and contingencies are reflected in the financial statements based on management’s assessment, including the advice of legal counsel, of the expected outcome of litigation or other dispute resolution proceedings, and/or the expected resolution of contingencies. Liabilities for estimated losses are accrued if the potential losses from any claims or legal proceedings are considered probable and the amounts can be reasonably estimated. Significant judgment is required in both the determination of probability of loss and the determination as to whether the amount can be reasonably estimated. Accruals are based only on information available at the time of the assessment due to the uncertain nature of such matters. As additional information becomes available, management reassesses potential liabilities related to pending claims and litigation and may revise its previous estimates, which could materially affect the Company’s results of operations in a given period. As of December 31, 2023 and December 31, 2022, the Company was not involved in any material legal proceedings except as described above. Indemnification In the normal course of business, the Company enters into contracts and agreements that contain a variety of representations and warranties and provide for general indemnifications. The Company’s exposure under these agreements is unknown because it involves claims that may be made against the Company in the future, but that have not yet been made. To date, the Company has not paid any claims or been required to defend any action related to its indemnification obligations. However, the Company may record charges in the future as a result of these indemnification obligations. The Company indemnifies each of its directors and officers for certain events or occurrences, subject to certain limits, while the director is or was serving at the Company’s request in such capacity, as permitted under Delaware law and in accordance with its certificate of incorporation and bylaws. The term of the indemnification period lasts as long as a director may be subject to any proceeding arising out of acts or omissions of such director in such capacity. The maximum amount of potential future indemnification is unlimited; however, the Company currently holds director liability insurance. This insurance allows the transfer of risk associated with the Company’s exposure and may enable it to recover a portion of any future amounts paid. The Company believes that the fair value of these indemnification obligations is minimal. Accordingly, the Company has not recognized any liabilities relating to these obligations as of December 31, 2023 and 2022.

Stockholders's Equity

Stockholders's Equity	12 Months Ended
	Dec. 31, 2023
Stockholders' Equity Note [Abstract]
Stockholders's Equity	Note 7. Stockholders' Equity Common Stock The Company’s certificate of incorporation provides for 200,000,000 authorized shares of common stock, par value $ 0.001 per share, and 10,000,000 authorized shares of preferred stock, par value $ 0.001 per share. The holders of common stock are entitled to receive dividends whenever funds are legally available, when and if declared by the board of directors. As of December 31, 2023, no dividends have been declared. Each share of common stock is entitled to one vote. At December 31, 2023 and 2022, the Company had reserved common stock for future issuances as follows: December 31, 2023 2022 Common stock options issued and outstanding 4,980,190 4,819,906 Common stock available for future grant 6,033,176 6,099,584 Restricted stock units outstanding 2,721,361 1,014,123 Shares available for future purchase under ESPP 1,488,227 1,226,123 15,222,954 13,159,736

Equity Incentive Plans

Equity Incentive Plans	12 Months Ended
	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Equity Incentive Plans	Note 8. Equity Incentive Plans 2011 Stock Option Plan and 2021 Equity Incentive Plan In 2011, the Company established its 2011 Stock Option Plan (the “2011 Plan”) that provided for the granting of stock options to employees and nonemployees of the Company. In July 2021, the board of directors and stockholders adopted and approved the 2021 Incentive Award Plan, (the “2021 Plan”). Under the 2021 Plan, the Company has the ability to issue incentive stock options ("ISOs"), nonqualified stock options ("NSOs"), stock appreciation rights, dividend equivalent rights, restricted stock awards, and restricted stock unit awards ("RSUs"). Options under the 2021 Plan can typically be granted for periods of up to ten years. For stock options granted to a grantee who, at the time the option is granted, owned stock representing more than 10% of the voting power of all classes of stock of the Company (or any parent or subsidiary of the Company), the term of the stock option may be granted for periods of up to five years. The ISOs and NSOs will be granted at a price per share not less than the fair value at the date of grant. The exercise price of a stock option granted to a 10% stockholder shall be not less than 110% of the grant date fair value of the shares. Options granted to new hires generally vest over a four-year period, with 25% of the shares vesting on the first anniversary of the grant date and the remaining shares vesting in 36 equal monthly installments thereafter; options granted as merit awards generally vest in 48 equal monthly installments following the grant date. RSUs granted generally vest over a four-year period with straight-line vesting in equal amounts. The Company initially reserved 5,200,000 shares of common stock for future issuance under the 2021 Plan. This initial reserve is subject to annual increase on the first day of each calendar year beginning on January 1, 2022 and ending on and including January 1, 2031. These annual increases are equal to the lesser of (i) 5% of the aggregate number of shares of common stock outstanding on the final day of the immediately preceding calendar year and (ii) such smaller number of shares of common stock as determined by the Board, subject to certain limitations. Pursuant to the evergreen provision, the initial share reserve was increased by 2,414,907 and 2,375,235 shares on January 1, 2023 and 2022, respectively. The 2011 Plan was superseded by the 2021 Plan at the time of the IPO and no further grants have been made under the 2011 Plan from the date the 2021 Plan became effective. The terms under the 2011 Plan are consistent with those described above for the 2021 Plan. At December 31, 2023 and 2022, there were 6,033,176 shares and 6,099,584 shares, respectively, of common stock available for issuance under the 2021 Plan. Stock Option Awards The following table summarizes stock option activity under the 2011 and 2021 Plans: Number of Weighted-Average Exercise Price Weighted-Average Average Intrinsic Value Outstanding, December 31, 2022 4,819,906 $ 9.67 7.7 $ 19,463 Grants 1,360,308 6.37 Forfeited/cancelled ( 829,897 ) 12.18 Exercised ( 370,127 ) 1.03 Outstanding, December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924 Vested and exercisable as of December 31, 2023 2,670,019 $ 8.62 6.4 $ 3,797 Vested and expected to vest as of December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924 The weighted-average grant-date fair values of options granted during the year ended December 31, 2023 and 2022 was $ 3.78 per share and $ 9.56 per share, respectively. The aggregate intrinsic value of options exercised was $ 1.7 million during the year ended December 31, 2023. The aggregate intrinsic value was calculated as the difference between the exercise prices of the underlying options and the estimated fair value of the common stock on the date of exercise. During the year ended December 31, 2023, the Company recorded stock-based compensation expense of $ 8.5 million related to options. As of December 31, 2023, the unrecognized stock-based compensation of unvested opti ons was $ 14.1 million, which is expected to be recognized over a weighted-average period of 1.8 years. Determination of Fair Value The Company estimated the fair value of stock options using the Black-Scholes option-pricing model. The fair value of stock options is recognized on a straight-line basis over the requisite service periods of the awards. The fair value of stock options was estimated using the following weighted-average assumptions: Years ended December 31, 2023 2022 Expected term (in years) 5.60 – 6.07 5.38 – 6.95 Expected volatility 60.72 % – 61.80 % 58.74 % – 64.97 % Risk-free interest rate 3.07 % – 4.35 % 1.35 % – 3.97 % Dividend yield – – Expected Term The expected term is calculated using the simplified method, which is available if there is insufficient historical data about exercise patterns and post vesting employment termination behavior. The simplified method is based on the vesting period and the contractual term for each grant or for each vesting tranche for awards with graded vesting. The midpoint of the vesting date and the maximum contractual expiration date is used as the expected term under this method. For awards with multiple vesting tranches, the time from grant until the midpoints for each of the tranches may be averaged to provide an overall expected term. Expected Volatility The Company used an average historical stock price volatility of a peer group of publicly traded companies to be representative of its expected future stock price volatility, as the Company did not have any trading history for its common stock. For purposes of identifying these peer companies, the Company considered the industry, stage of development, size, and financial leverage of potential comparable companies. For each grant, the Company measured historical volatility over a period equivalent to the expected term. Risk-Free Interest Rate The risk-free interest rate is based on the implied yield currently available on US Treasury zero-coupon issues with remaining terms equivalent to the expected term of a stock award. Expected Dividend Rate The Company has not paid, and does not anticipate paying, any dividends in the near future. Accordingly, the Company has estimated the dividend yield to be 0 %. Restricted Stock Units RSUs are share awards that entitle the holder to receive shares of common stock upon vesting. The RSUs cannot be transferred, and the awards are subject to forfeiture if the holder’s employment terminates prior to the release of the vesting restrictions. The RSUs generally vest over a four-year period with straight-line vesting in equal amounts, provided the employee remains continuously employed with the Company. The fair value of the RSUs is equal to the closing price of the Company’s common stock on the grant date. The following table summarizes restricted share award activity: Number of Weighted-Average Grant Date Fair Value Per Share Outstanding, December 31, 2022 1,014,123 $ 14.25 Grants 2,392,662 6.28 Forfeited/cancelled ( 441,759 ) 12.14 Vested ( 243,665 ) 13.96 Outstanding, December 31, 2023 2,721,361 $ 7.61 During the year ended December 31, 2023, the Company recorded stock-based compensation of $ 5.5 million related to RSUs. As of December 31, 2023, the unrecognized stock-based compensation associated with unvested RSUs was $ 16.2 million, which is expected to be recognized over a weighted-average period of 2.9 years. Employee Stock Purchase Plan In July 2021, the board of directors and stockholders adopted and approved the 2021 Employee Stock Purchase Plan (the “ESPP”). The Company initially reserved 850,000 shares of common stock for future issuance under the ESPP. This initial reserve is subject to annual increase on the first day of each calendar year beginning on January 1, 2022 and ending on and including January 1, 2031. These annual increases shall be equal to the lesser of (i) 1% of the aggregate number of shares of common stock outstanding on the final day of the immediately preceding calendar year and (ii) such smaller number of shares of common stock as determined by the Board, subject to certain limitations. Pursuant to the evergreen provision, the initial share reserve was increased by 482,981 and 475,074 shares on January 1, 2023 and 2022, respectively. The Company has two offering periods annually, running for six-months, with the first offering period beginning in the second quarter, and the second offering period beginning in the fourth quarter. The purchase of shares for participants in the ESPP occurs at the conclusion of each offering period. For the year ended December 31, 2023, participants in the ESPP purchased 220,877 shares for a total of $ 0.9 million. As of December 31, 2023, the Company has collected payroll withholdings of $ 0.1 million in the current offering period for the purchase of shares under the ESPP. The Company recorded stock-based compensation expense associated with the ESPP of $ 0.6 million for the year ended December 31, 2023. As of December 31, 2023 and 2022, there were 1,488,227 shares and 1,226,123 shares of common stock available for issuance under the ESPP. The fair value of shares to be issued under the ESPP was estimated using the Black-Scholes valuation model with the following assumptions for the years ended December 31, 2023 and 2022, respectively: Years ended December 31, 2023 2022 Expected term (in years) 0.48 - 0.50 0.48 - 0.50 Expected volatility 66.72 % - 197.51 % 76.50 % - 97.38 % Risk-free interest rate 4.62 % - 5.40 % 1.51 % - 4.62 % Dividend yield – – Stock-Based Compensation The following is a summary of stock-based compensation expense by function (in thousands): Years Ended December 31, 2023 2022 Cost of goods sold $ 289 $ 167 Research and development 2,111 1,315 Selling, general and administrative 12,181 11,481 Total stock-based compensation expense $ 14,581 $ 12,963

Net Loss per Share Attributable

Net Loss per Share Attributable to Common Stockholders	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Net Loss per Share Attributable to Common Stockholders	Note 9. Net Loss per Share Attributable to Common Stockholders Basic net loss per share is computed by dividing the net loss by the weighted-average number of common shares outstanding for the period. As the Company reported a net loss for the years ended December 31, 2023 and 2022, basic net loss per share is the same as diluted net loss per share as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation. The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders (in thousands, except share and per share data): Years Ended December 31, 2023 2022 Numerator: Net loss attributable to common stockholders $ ( 55,547 ) $ ( 86,242 ) Denominator: Weighted-average shares of common stock 48,628,940 47,849,058 Net loss per share attributable to common $ ( 1.14 ) $ ( 1.80 ) The following outstanding shares of potentially dilutive securities were excluded from the computation of diluted net loss per share attributable to common stockholders for the period presented because including them would have been antidilutive: December 31, 2023 2022 Options to purchase common stock 4,980,190 4,819,906 Restricted stock units 2,721,361 1,014,123 Total 7,701,551 5,834,029

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Note 10. Income Taxes The Company’s income tax provision for the years ended December 31, 2023 and 2022, consists of the following (in thousands): Current December 31, 2023 2022 Federal $ — $ — Foreign 110 47 State — — Provision (benefit) for income taxes $ 110 $ 47 The Company's components of income/(loss) before the provision for income taxes includes domestic loss of $ 55.7 million and $ 86.0 million for the years ended December 31, 2023 and 2022, respectively. Foreign income/(loss) for the year ended December 31, 2023 was income of $ 0.2 income, while the Company recorded a net loss of $ 0.2 million for the year ended December 31, 2022. Deferred tax assets and liabilities reflect the net tax effect of temporary differences between carrying value of assets and liabilities for financial reporting purposes and the tax basis of these assets and liabilities as measured by income tax law. The income tax effect of temporary differences that give rise to deferred tax assets and (liabilities) consist of the following (in thousands): December 31, 2023 2022 Deferred tax assets: Net operating loss carryforwards $ 60,753 $ 52,616 Deferred compensation 5,547 3,974 Research and development expenses 4,566 1,743 Research and development credits 2,357 1,918 Disallowed interest expense carryover 830 444 Operating lease liability 388 436 Provision for bad debt 310 398 Other 285 144 Gross deferred tax assets 75,036 61,673 Less: Valuation allowance ( 74,655 ) ( 61,251 ) Deferred tax assets, net of valuation allowance 381 422 Operating lease right-of-use assets ( 381 ) ( 422 ) Deferred tax liabilities: ( 381 ) ( 422 ) Net deferred tax assets $ — $ — Internal Revenue Code (IRC) Section 382 limits the use of federal net operating losses and income tax credit carryforwards in certain situations where changes occur in stock ownership of a company. If the Company should have an ownership change of more than 50% of the value of the Company’s capital stock, utilization of the carryforwards could be restricted. The reconciliation of the statutory federal income tax rate to the Company’s effective tax rate is as follows (in thousands): December 31, 2023 2022 Tax at statutory federal rate 21 % 21 % State tax, net of federal benefit 5 % 5 % Research and development credit 2 % 1 % Change in valuation allowance ( 25 )% ( 26 )% Other ( 3 )% ( 1 )% Effective tax rate — — A valuation allowance is recorded when it is more likely than not that some portion of the deferred tax assets will not be realized. As of each reporting date, the Company's management considers all evidence, both positive and negative, that could impact management's view with regard to future realization of deferred tax assets. As of December 31, 2023, a full valuation allowance for deferred tax assets was recorded as management believes it is not more likely than not that all of the deferred tax assets will be realized. At December 31, 2023 and 2022, the Company has a net operating loss carryforward for federal income tax purposes of approximately $ 235.5 million and $ 204.6 million, respectively. At December 31, 2023 and 2022, the Company has a net operating loss carryforward for state income tax purposes of approximately $ 201.6 million and $ 187.5 million, respectively. Of the Company's federal net operating loss carryovers, $ 14.8 million was generated before January 1, 2018 and is subject to a 20-year carryforward period. The remaining $ 220.7 million can be carried forward indefinitely but is subject to an 80 % taxable income limitation. The pre-2018 federal and certain state net operating losses will begin to expire in 2031 and 2032, respectively, if not utilized . As of December 31, 2023 and 2022, the Company has federal research and development income tax credit carryforwards of approximately $ 1.9 million and $ 1.5 million, respectively. As of December 31, 2023 and 2022, the Company has state research and development income tax credit carryforwards of approximately $ 1.7 million and $ 1.5 million, respectively. The Federal income tax credits begin to expire in 2032. The California Research and Development credits can be carried forward indefinitely. The total amount of uncertain tax positions ("UTP") on research and development tax credits is $ 0.9 million and $ 0.7 million as of December 31, 2023 and 2022, respectively. The Company does not expect any significant change to the UTP balances in the next 12 months. As of December 31, 2023 and 2022, the Company has business interest expense carryforwards of $ 0.8 million and $ 0.4 million, respectively. Business interest expense can be carried forward indefinitely. The following table summarizes the activity related to the unrecognized tax benefits (in thousands): December 31, 2023 2022 Unrecognized tax benefits at the beginning of the year $ 741 $ 580 Additions based on tax positions related to the current year 162 161 Additions for tax positions of prior years — — Unrecognized tax benefits at the end of the year $ 903 $ 741 The Company does not have any material uncertain tax positions as of December 31, 2023 and does not expect any significant change to such balances in the next twelve months. The Company currently has no federal or state tax examinations in progress nor has it had any federal or state tax examinations since its inception. Due to the history of net operating losses, the Company’s federal and state tax returns remain open to examination by the tax authorities

Segment Information

Segment Information	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Segment Information	Note 11. Segment Information The Company has two reportable operating segments which are determined on the basis of the product portfolio: Surgical Glaucoma and Dry Eye. The operating and reportable segments were determined based on how the Company’s Chief Executive Officer, its Chief Operating Decision Maker (“CODM”), views and evaluates the Company’s operations. The CODM allocates resources to and evaluates the financial performance of each operating segment primarily based on gross profit and gross profit margin. The Surgical Glaucoma segment includes sales of the Company’s OMNI® Surgical System and SION® Surgical Instrument for use in minimally invasive glaucoma procedures. The Dry Eye segment includes sales of the Company’s TearCare® System and related components. The following table summarizes select operating results information for each reportable segment (dollars in thousands): Years Ended December 31, 2023 2022 Revenue Surgical Glaucoma $ 74,310 $ 65,594 Dry Eye 6,746 5,737 Total 81,056 71,331 Cost of goods sold Surgical Glaucoma 8,830 8,295 Dry Eye 3,051 4,066 Total 11,881 12,361 Gross profit Surgical Glaucoma 65,480 57,299 Dry Eye 3,695 1,671 Total 69,175 58,970 Operating expense 126,449 142,924 Loss from operations ( 57,274 ) ( 83,954 ) Interest expense ( 5,408 ) ( 4,466 ) Other expense, net 7,245 2,225 Loss before income tax $ ( 55,437 ) $ ( 86,195 ) The Company does not allocate any income and expenses beyond revenue and cost of goods sold to the reportable operating segments in its reporting to the CODM. No asset information is provided for reportable operating segments because they are not reviewed by the CODM on segment basis. Substantially all of the Company’s revenue is generated from sales in the United States.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2023
Subsequent Events [Abstract]
Subsequent Events	Note 12. Subsequent Events The Company evaluated subsequent events through March 12, 2024, the date on which the consolidated financial statements were available for issuance. Hercules Capital Loan Agreement In January 2024, the Company entered into the Hercules Credit Agreement with Hercules and certain of its affiliates, which provides for a maximum $ 65.0 million credit facility. At closing, Hercules funded $ 35.0 million, which the Company utilized to pay in full the balance due under the MidCap Term Loan. The Hercules Credit Agreement has a maturity date of July 1, 2028 , with an interest only period of 30 months, which is extendable to up to 36 months. The stated floating interest rate under the Hercules Credit Agreement is the greater of 10.35 % or the Prime Rate plus 2.35 %, with an initial interest rate of 10.85 %. See Note 5, Debt for additional information.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America ("US GAAP"). The Company’s consolidated financial statements include the accounts of the Company and its wholly owned subsidiaries, Sight Sciences UK, Ltd and Sight Sciences GmbH. All intercompany balances and transactions have been eliminated in consolidation.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with US GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent liabilities at the date of the financial statements, and the reported amounts of revenues and expense during the reporting period. The most significant estimates related to the provision for credit losses, inventory excess and obsolescence, the selection of useful lives of property and equipment, determination of the fair value of stock option grants, and provisions for income taxes and contingencies. Management evaluates its estimates and assumptions on an ongoing basis using historical experience and other factors, including the current economic environment, and makes adjustments when facts and circumstances dictate. These estimates are based on information available as of the date of the financial statements. Actual results could differ from these estimates and such differences could be material to the Company’s financial position and results of operations.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company’s financial instruments consist of cash and cash equivalents, accounts receivable, accounts payable, accrued liabilities, and short-term and long-term debt. The Company's cash equivalents include U.S. treasury securities that are classified as held-to-maturity and recorded at amortized cost in the financial statements. The Company states accounts receivable, accounts payable, and accrued and other current liabilities at their carrying value, which approximates fair value due to the short time to the expected receipt or payment. The carrying amount of the Company’s short-term debt approximates its fair value as the effective interest rate approximates market rates currently available to the Company.
Concentration Of Credit Risk	Concentration of Credit Risk Financial instruments that subject the Company to concentration of credit risk consist of cash and cash equivalents and accounts receivable. The Company’s cash and cash equivalents are deposited with a high-quality financial institution. Deposits at this institution may, at times, exceed federally insured limits. Management believes that this financial institution is financially sound and, accordingly, that minimal credit risk exists. The Company has not experienced any losses on its deposits of cash and cash equivalents. The Company relies on third-party contract manufacturers for the manufacture of all of its commercial products currently available for sale, and also depends on a limited number of single source suppliers for some of the components, accessories, and materials used in the manufacture and assembly of its OMNI, TearCare and SION products, and any shortfall in the supply chain may cause its business to materially suffer. Disruption in production or its supply chain would have a negative impact on the Company’s financial position, results of operations and cash flows. For the years ended December 31, 2023 and 2022, there were no customers that represented 10 % or more of the Company's revenue.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with an original maturity of 90 days or less, when purchased, to be cash and cash equivalents. As of December 31, 2023 and 2022, cash and cash equivalents includes $ 129.1 million and $ 144.3 million of U.S. treasury securities that are classified as held-to-maturity and recorded at amortized cost in the financial statements, respectively. As of December 31, 2023 and 2022, the remainder of cash and cash equivalents consists primarily of checking and savings deposits, which are recorded at cost, which approximate fair value. The Company’s cash balances exceed those that are federally insured. To date, the Company has not recognized any losses caused by uninsured balances.
Accounts Receivable and Provision for Credit Losses	Accounts Receivable and Provision for Credit Losses Accounts receivable are stated at invoiced amounts, net of estimated provisions for credit losses. The Company’s provision for credit losses methodology for receivables is developed using its historical collection experience, current and future economic market conditions, and a review of the current aging status and financial condition of its customers. The Company uses its judgment, based on the best available facts and circumstances, and records a provision against amounts due to reduce the receivable to the amount that is expected to be collected. These specific provisions are reevaluated and adjusted as additional information is received that impacts the amount reserved. To date, the Company has not experienced material credit-related losses. The provision for credit losses was $ 1.2 million and $ 1.0 million as of December 31, 2023 and 2022, respectively.
Inventory, net	Inventory, net Inventory represents raw materials and finished goods purchased from third-party suppliers and manufacturers. Inventory is valued at the lower of cost or net realizable value. Cost is determined using actual costs on a first-in, first-out basis for all inventory. Net realizable value is determined as the estimated selling prices in the ordinary course of business, less reasonably predictable costs of completion, disposal, and transportation. As of December 31, 2023, the Company’s inventory balance consisted of finished goods of $ 7.3 million and raw materials of $ 1.0 million. As of December 31, 2022, the Company’s inventory consisted of finished goods of $ 5.8 million and raw materials of $ 0.4 million. The Company regularly reviews inventory quantities in consideration of actual loss experiences, projected future demand, and remaining shelf life to record a provision for excess and obsolete inventory when appropriate. The Company’s policy is to write down inventory that has become obsolete, inventory that has a cost basis in excess of its expected lower of cost or net realizable value, and inventory in excess of expected requirements. The estimate of excess quantities is judgmental and primarily dependent on the Company’s estimates of future demand for the particular product. As of December 31, 2023 and 2022, the Company has reserves for excess and obsolete inventory of $ 0.5 million and $ 0.1 million.
Property and Equipment, net	Property and Equipment, net Property and equipment are recorded at cost, less accumulated depreciation. Repairs and maintenance costs are expensed as incurred. Depreciation is calculated using the straight-line method over the estimated useful lives of the assets, typically two to five years. When assets are retired or otherwise disposed of, the cost and accumulated depreciation are removed from the consolidated balance sheets and any resulting gain or loss is reflected in the consolidated statements of operations and consolidated loss in the period realized. Construction-in-process assets consist primarily of tools and equipment that have not yet been placed in service. These assets are stated at cost and are not depreciated. Once the assets are placed into service, assets are reclassified to the appropriate asset class based on their nature and depreciated in accordance with the useful lives above.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets The Company assesses long-lived assets, including property and equipment, whenever events or changes in business circumstances indicate that the carrying amount of the assets may not be fully recoverable. If indicators of impairment exist, an impairment loss may be recognized when estimated undiscounted future cash flows expected to result from the use of the assets and their eventual disposition are less than their carrying amount. Impairment, if any, is measured as the amount by which the carrying amount of the long-lived assets exceeds their fair value. Fair value is determined through various valuation techniques, including discounted cash flow models, quoted market values, and third-party independent appraisals, as considered necessary. The Company did no t record any impairment of long-lived assets for the years ended December 31, 2023 and 2022.
Leases	Leases Contractual arrangements that meet the definition of a lease are classified as operating or finance leases and are recorded on the consolidated balance sheets as both a right-of-use asset (“ROU asset”) and lease liability, calculated by discounting fixed lease payments over the lease term at the Company’s incremental borrowing rate (“IBR”). Lease ROU assets and lease obligations are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. The Company currently does not have any finance leases. As the implicit rates for the Company's operating leases are not determinable, the Company uses an IBR based on the information available at the respective lease commencement dates to determine the present value of future payments. IBR represents the interest rate that the Company would expect to incur at lease commencement to borrow an amount equal to the lease payments on a collateralized basis with similar terms and payments, in an economic environment where the leased asset is located. The Company does not recognize lease ROU assets or lease liabilities for short-term leases, if any, having initial terms of 12 months or less at lease commencement as an accounting policy election, and recognizes rent expense on a straight-line basis over the lease term for these types of leases.
Revenue Recognition	Revenue Recognition The Company applies the following five steps in order to determine the appropriate amount of revenue to be recognized as it fulfills its obligations under each of its arrangements: • Identify the contract with a customer, • Identify the performance obligations in the contract, • Determine the transaction price, • Allocate the transaction price to performance obligations in the contract, and • Recognize revenue as the performance obligations are satisfied. Revenue recognized during the years ended December 31, 2023 and 2022 relates entirely to the sale of the Company’s products within the Surgical Glaucoma and Dry Eye segments. These sales are primarily to hospitals, medical centers, and eyecare professionals ("ECPs") throughout the United States. Sales are generally made through sales representatives and distributors. The Company’s revenue arrangements consist of a single performance obligation. Revenue is recognized at the point in time when control of the promised goods transfer to the Company’s customers. Revenue is measured at the amount of consideration expected to be received in exchange for the transfer of goods. The amount of revenue that is recognized is based on the transaction price, which represented the invoiced amounts and includes estimates of variable consideration, such as discounts, where applicable. The Company does not offer right of return, except in the case where items are defective as manufactured, and the company does not typically provide customers with a right to a refund. The amount of variable consideration included in the transaction price may be constrained and is included only to the extent that it is probable that a significant reversal in the amount of the cumulative revenue recognized under the contract will not occur in a future period. Payment terms, typically 30 days, are offered to customers and do not include a significant financing component. The Company extends credit to customers based upon their financial condition and credit history and generally require no collateral. The Company does not have any contract balances related to product sales. Shipping and handling costs incurred for the delivery of goods to customers are included in cost of goods sold. In cases where the Company bills shipping and handling cost to customers, the Company classifies those amounts in net revenue. As a practical expedient, the Company recognizes the incremental costs of obtaining contracts, such as sales commissions, as an expense when incurred since the amortization period of the asset we otherwise would have recognized is one year or less. Sales commissions are recorded within selling, general, and administrative expenses in the consolidated statements of operations and comprehensive loss.
Cost Of Goods Sold	Cost of Goods Sold The Company purchases its components and products from third-party suppliers and manufacturers. Cost of goods sold consists primarily of costs related to materials, manufacturing overhead costs, reserves for excess, and obsolete and non-sellable inventories. Cost of goods sold also includes depreciation expense for production equipment and certain direct costs, such as shipping and handling costs.
Research and Development	Research and Development The Company expenses research and development costs as incurred. Research and development expenses consist primarily of product development, clinical studies to develop and support the Company’s products, regulatory expenses, medical affairs, and other costs associated with products and technologies that are in development. Research and development expenses include employee compensation, including stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation, and an allocation of facility overhead expenses.
Selling, General and Administrative	Selling, General and Administrative Selling, general and administrative expenses include compensation, employee benefits, and stock-based compensation for executive management, commercial, finance administration, and human resources; facility costs (including rent); bad debt costs; professional service fees; and other general overhead costs, including depreciation to support the Company’s operations.
Advertising Expense	Advertising Expense The Company expenses advertising costs as incurred. Advertising expenses for fiscal years 2023 and 2022 were $ 2.1 million and $ 2.6 million, respectively, included in selling, general, and administrative expenses in the consolidated statements of operations and comprehensive loss.
Stock-Based Compensation	Stock-Based Compensation The Company's equity incentive plan permits the grant of stock-based awards, such as stock options and restricted stock units ("RSUs"), to employees, directors and consultants. The Company’s employee stock purchase plan (“ESPP”) allows employees to purchase stock from the Company at a discount. The Company measures and records the expense related to stock-based payment awards based on the fair value of those awards as determined on the date of grant. The Company recognizes stock-based compensation expense over the requisite service period of the individual grant, generally equal to the vesting period and uses the straight- line method to recognize stock-based compensation, and accounts for forfeitures as they occur. The Company selected the Black-Scholes-Merton (“Black-Scholes”) option-pricing model as the method for determining the estimated fair value for stock options and the ESPP. The Black-Scholes option-pricing model requires the use of highly subjective and complex assumptions, which determine the fair value of share-based awards, including the option’s expected term, expected volatility of the underlying stock, risk-free interest rate and expected dividend yield. The fair value of RSU awards is determined based on the number of units granted and the closing price of the Company's common stock as of the grant date.
Currency Remeasurement	Currency Remeasurement Foreign currency transaction gains and losses are recorded in other income (expense), net in the Company’s consolidated statements of operations and comprehensive loss. Such amounts have not been material for all periods presented.
Income Taxes	Income Taxes The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred tax assets and liabilities are determined based on the differences between the financial reporting and the tax bases of assets and liabilities and are measured using the enacted tax rates and laws that will be in effect when the differences are expected to reverse. Management makes an assessment of the likelihood that the resulting deferred tax assets will be realized. A valuation allowance is provided when it is more likely than not that some portion or all off a deferred tax asset will not be realized. Due to the Company's historical operating performance and the recorded cumulative net losses in prior fiscal periods, the net deferred tax assets have been fully offset by a valuation allowance. The Company recognizes uncertain income tax positions at the largest amount that is more likely than not to be sustained upon audit by relevant taxing authority. An uncertain income tax position will not be recognized if it has less than a 50% likelihood of being sustained. Changes in recognition or measurement are reflected in the period in which judgment occurs. The Company's policy is to recognize interest and penalties related to the underpayment of income tax as a component of provision for income taxes.
Comprehensive Loss	Comprehensive Loss Comprehensive loss represents all changes in stockholders’ equity except those resulting from distributions to stockholders. There have been no items qualifying as other comprehensive income (loss) and, therefore, for all periods presented, there was no difference between comprehensive loss and the Company’s reported net loss.
Net Loss Per Share Attributable to Common Stockholders	Net Loss Per Share Attributable to Common Stockholders Basic and diluted net loss per share attributable to common stockholders is presented in conformity with the two-class method required for participating securities. Basic and diluted net loss per share attributable to common stockholders is computed by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding for the period without consideration of potentially dilutive securities. The Company’s potentially dilutive shares, which consist of outstanding common stock options and restricted stock units, were excluded in the computation of diluted net loss per share for the period as the result would be anti-dilutive.
Emerging Growth Company and Smaller Reporting Company	Emerging Growth Company and Smaller Reporting Company The Company is an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012, as well as a "smaller reporting company, as defined by the Securities and Exchange Commission per Rule 12b-2 of the Exchange Act. As such the Company is eligible for exemptions from various reporting requirements applicable to other public companies that are not emerging growth companies or smaller reporting companies, including reduced reporting and extended transition periods to comply with new or revised accounting standards for public business entities. The Company has elected to avail themselves of this exemption and, therefore, will not be subject to the timeline for adopting new or revised accounting standards for public business entities that are not emerging growth companies, and will follow the transition guidance applicable to private companies.
Recent Accounting Pronouncements	Recent Accounting Pronouncements Accounting Standards Adopted In June 2016, the Financial Accounting Standards Board (the "FASB") issued Accounting Standards Updated ("ASU") No. 2016-13, Financial Instruments—Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments. The ASU amends the impairment model by requiring entities to use a forward-looking approach based on expected losses to estimate credit losses on certain types of financial instruments, including trade receivables and available-for-sale debt securities. The guidance was effective for the Company beginning in the first quarter of 2023. The amendments in ASU 2016-13 were adopted with no material impact on the Company's consolidated financial statements. Accounting Standards Not Yet Adopted In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosure. The ASU updates reportable segment disclosure requirements, primarily through requiring enhanced disclosures about significant segment expenses and information used to assess segment performance. The ASU is effective for fiscal years beginning after December 15, 2023, with early adoption permitted. The Company is currently evaluating the impact of adopting this ASU on its disclosures. In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. The ASU includes amendments requiring enhanced income tax disclosures, primarily related to standardization and disaggregation of rate reconciliation categories and income taxes paid by jurisdiction. The guidance is effective for fiscal years beginning after December 15, 2024, with early adoption permitted, and should be applied either prospectively or retrospectively. The Company is currently evaluating the impact of adopting this ASU on its disclosures. As of December 31, 2023, there are no additional ASUs issued and not yet adopted that are expected to have a material impact on the Company's financial statements and related disclosures.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2023
Summary of Held-to-maturity debt securities at amortized cost in the financial statements	These securities are classified as held-to-maturity and all have been purchased with original maturities of 90 days or less. Held-to-maturity debt securities are recorded at amortized cost in the financial statements. As of December 31, 2023 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. Treasury Securities $ 129,113 $ 28 $ — $ 129,141 As of December 31, 2022 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. Treasury Securities $ 144,319 $ 45 $ — $ 144,364

Balance Sheet Components (Table

Balance Sheet Components (Tables)	12 Months Ended
	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Summary of Property and Equipment, Net	Property and equipment, net consist of the following (in thousands): As of December 31, 2023 2022 Tools and equipment $ 2,010 $ 2,173 Computer equipment and software 37 37 Furniture and fixtures 323 282 Leasehold improvements 38 38 Construction in process 859 475 3,267 3,005 Less: Accumulated depreciation ( 1,627 ) ( 1,434 ) Property and equipment, net $ 1,640 $ 1,571
Summary of Accrued and Other Current Liabilities	Accrued and other current liabilities consist of the following (in thousands): As of December 31, 2023 2022 Accrued expenses $ 1,639 $ 5,307 Current portion of lease liabilities 573 1,033 Short term interest payable 375 348 Other accrued liabilities 1,187 1,087 Total accrued and other current liabilities $ 3,774 $ 7,775
Summary of Other Noncurrent Liabilities	Other noncurrent liabilities consist of the following (in thousands): As of December 31, 2023 2022 Long term interest payable $ 1,524 $ 1,194 Noncurrent portion of lease liabilities 914 635 Other noncurrent liabilities 38 38 Total other noncurrent liabilities $ 2,476 $ 1,867

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Schedule of Long-term and Short-term Debt	Long-term and short-term debt, as of December 31, 2023 and 2022 was as follows (in thousands): As of December 31, 2023 2022 MidCap Term Loan $ 35,000 $ 35,000 Total principal payments due 35,000 35,000 Less: debt discount related to warrant liability and issuance costs ( 1,073 ) ( 1,687 ) Total amounts outstanding 33,927 33,313 Less: Current portion, net of discount ( 2,219 ) — Long-term debt $ 31,708 $ 33,313
Repayment Schedule Relating to the Company's Debt	The repayment schedule relating to the principal amount of the MidCap Term Loan as of December 31, 2023, is as follows (in thousands): Amount 2024 ( 2,917 ) 2025 ( 32,083 ) Thereafter — Total repayments $ ( 35,000 )

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Schedule of Operating Lease Expense Recognized and Supplemental Cash Flow	Operating lease expense and supplemental cash flow information related to operating leases for the years ended December 31, 2023 and 2022 were as follows (in thousands): Years Ended December 31, 2023 2022 Operating lease expense $ 1,157 $ 732 Cash paid for operating leases 1,158 731 New operating lease assets obtained in exchange for 849 660
Schedule of Aggregate Future Minimum Lease Payments	Aggregate future minimum lease payments at December 31, 2023 under these noncancelable operating leases was as follows (in thousands): As of December 31, 2023 2024 $ 700 2025 548 2026 468 Total future minimum lease payments $ 1,716 Less: imputed interest ( 229 ) Present value of future minimum lease payments $ 1,487 Less: current portion of operating lease liability ( 573 ) Operating lease liabilities - noncurrent $ 914

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2023
Stockholders' Equity Note [Abstract]
Reserved Common Stock for Future Issuances	At December 31, 2023 and 2022, the Company had reserved common stock for future issuances as follows: December 31, 2023 2022 Common stock options issued and outstanding 4,980,190 4,819,906 Common stock available for future grant 6,033,176 6,099,584 Restricted stock units outstanding 2,721,361 1,014,123 Shares available for future purchase under ESPP 1,488,227 1,226,123 15,222,954 13,159,736

Equity Incentive Plans (Tables)

Equity Incentive Plans (Tables)	12 Months Ended
	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of Stock Option Activity	The following table summarizes stock option activity under the 2011 and 2021 Plans: Number of Weighted-Average Exercise Price Weighted-Average Average Intrinsic Value Outstanding, December 31, 2022 4,819,906 $ 9.67 7.7 $ 19,463 Grants 1,360,308 6.37 Forfeited/cancelled ( 829,897 ) 12.18 Exercised ( 370,127 ) 1.03 Outstanding, December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924 Vested and exercisable as of December 31, 2023 2,670,019 $ 8.62 6.4 $ 3,797 Vested and expected to vest as of December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924
Summary of Weighted Average Valuation Assumptions Used to Estimate Fair Value of Employee Stock Options	The Company estimated the fair value of stock options using the Black-Scholes option-pricing model. The fair value of stock options is recognized on a straight-line basis over the requisite service periods of the awards. The fair value of stock options was estimated using the following weighted-average assumptions: Years ended December 31, 2023 2022 Expected term (in years) 5.60 – 6.07 5.38 – 6.95 Expected volatility 60.72 % – 61.80 % 58.74 % – 64.97 % Risk-free interest rate 3.07 % – 4.35 % 1.35 % – 3.97 % Dividend yield – –
Summary of restricted share award activity	The following table summarizes restricted share award activity: Number of Weighted-Average Grant Date Fair Value Per Share Outstanding, December 31, 2022 1,014,123 $ 14.25 Grants 2,392,662 6.28 Forfeited/cancelled ( 441,759 ) 12.14 Vested ( 243,665 ) 13.96 Outstanding, December 31, 2023 2,721,361 $ 7.61
Summary of Stock-Based Compensation Expense by Function	The following is a summary of stock-based compensation expense by function (in thousands): Years Ended December 31, 2023 2022 Cost of goods sold $ 289 $ 167 Research and development 2,111 1,315 Selling, general and administrative 12,181 11,481 Total stock-based compensation expense $ 14,581 $ 12,963
Two Thousand Twenty One Employee Stock Purchase Plan [ Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of Weighted Average Valuation Assumptions Used to Estimate Fair Value of Employee Stock Options	The fair value of shares to be issued under the ESPP was estimated using the Black-Scholes valuation model with the following assumptions for the years ended December 31, 2023 and 2022, respectively: Years ended December 31, 2023 2022 Expected term (in years) 0.48 - 0.50 0.48 - 0.50 Expected volatility 66.72 % - 197.51 % 76.50 % - 97.38 % Risk-free interest rate 4.62 % - 5.40 % 1.51 % - 4.62 % Dividend yield – –

Net Loss per Share Attributab_2

Net Loss per Share Attributable to Common Stockholders (Tables)	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Schedule of Computation of Basic and Diluted Net Loss per Share Attributable to Common Stockholders	The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders (in thousands, except share and per share data): Years Ended December 31, 2023 2022 Numerator: Net loss attributable to common stockholders $ ( 55,547 ) $ ( 86,242 ) Denominator: Weighted-average shares of common stock 48,628,940 47,849,058 Net loss per share attributable to common $ ( 1.14 ) $ ( 1.80 )
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following outstanding shares of potentially dilutive securities were excluded from the computation of diluted net loss per share attributable to common stockholders for the period presented because including them would have been antidilutive: December 31, 2023 2022 Options to purchase common stock 4,980,190 4,819,906 Restricted stock units 2,721,361 1,014,123 Total 7,701,551 5,834,029

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Schedule of Income Tax Provision	The Company’s income tax provision for the years ended December 31, 2023 and 2022, consists of the following (in thousands): Current December 31, 2023 2022 Federal $ — $ — Foreign 110 47 State — — Provision (benefit) for income taxes $ 110 $ 47
Schedule of Tax Effects of Temporary Differences and Deferred Tax Assets and Liabilities	The income tax effect of temporary differences that give rise to deferred tax assets and (liabilities) consist of the following (in thousands): December 31, 2023 2022 Deferred tax assets: Net operating loss carryforwards $ 60,753 $ 52,616 Deferred compensation 5,547 3,974 Research and development expenses 4,566 1,743 Research and development credits 2,357 1,918 Disallowed interest expense carryover 830 444 Operating lease liability 388 436 Provision for bad debt 310 398 Other 285 144 Gross deferred tax assets 75,036 61,673 Less: Valuation allowance ( 74,655 ) ( 61,251 ) Deferred tax assets, net of valuation allowance 381 422 Operating lease right-of-use assets ( 381 ) ( 422 ) Deferred tax liabilities: ( 381 ) ( 422 ) Net deferred tax assets $ — $ —
Summery statutory federal income tax rate	The reconciliation of the statutory federal income tax rate to the Company’s effective tax rate is as follows (in thousands): December 31, 2023 2022 Tax at statutory federal rate 21 % 21 % State tax, net of federal benefit 5 % 5 % Research and development credit 2 % 1 % Change in valuation allowance ( 25 )% ( 26 )% Other ( 3 )% ( 1 )% Effective tax rate — —
Schedule of Unrecognized Tax Benefits Roll Forward	The following table summarizes the activity related to the unrecognized tax benefits (in thousands): December 31, 2023 2022 Unrecognized tax benefits at the beginning of the year $ 741 $ 580 Additions based on tax positions related to the current year 162 161 Additions for tax positions of prior years — — Unrecognized tax benefits at the end of the year $ 903 $ 741

Segment Information (Tables)

Segment Information (Tables)	12 Months Ended
	Dec. 31, 2023
Segment Reporting [Abstract]
Schedule of Segment Reporting Information	The following table summarizes select operating results information for each reportable segment (dollars in thousands): Years Ended December 31, 2023 2022 Revenue Surgical Glaucoma $ 74,310 $ 65,594 Dry Eye 6,746 5,737 Total 81,056 71,331 Cost of goods sold Surgical Glaucoma 8,830 8,295 Dry Eye 3,051 4,066 Total 11,881 12,361 Gross profit Surgical Glaucoma 65,480 57,299 Dry Eye 3,695 1,671 Total 69,175 58,970 Operating expense 126,449 142,924 Loss from operations ( 57,274 ) ( 83,954 ) Interest expense ( 5,408 ) ( 4,466 ) Other expense, net 7,245 2,225 Loss before income tax $ ( 55,437 ) $ ( 86,195 )

The Company and Nature of Bus_2

The Company and Nature of Business - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Accumulated deficit	$ (294,790)	$ (239,243)
Net loss	$ (55,547)	$ (86,242)

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) Customer	Dec. 31, 2022 USD ($) Customer
Subsidiary Sale Of Stock [Line Items]
Accounts Receivable, Allowance for Credit Loss	$ 1,200	$ 1,000
Inventory finished goods	7,300	5,800
Inventory raw materials	1,000	400
Reserves for excess and obsolete inventory	500	100
Cash and cash equivalents	138,129	185,000
Impairment of long lived assets	0	0
Advertising expense	$ 2,100	2,600
Lease term	12 months
US Treasury Securities
Subsidiary Sale Of Stock [Line Items]
Cash and cash equivalents	$ 129,100	$ 144,300
Customer Concentration Risk [Member] | Revenue Benchmark [Member]
Subsidiary Sale Of Stock [Line Items]
Number of major customers | Customer	0	0
Minimum [Member] | Customer Concentration Risk [Member] | Revenue Benchmark [Member]
Subsidiary Sale Of Stock [Line Items]
Concentration risk percentage	10%	10%

Fair value Measurement - Additi

Fair value Measurement - Additional Information (Details) - Fair Value Recurring - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Treasury bills	$ 129.1	$ 144.3
Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Amount	$ 33.9	$ 33.3

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Held-to-maturity debt securities at amortized cost in the financial statement (Details) - US Treasury Securities - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Amortized Cost	$ 129,113	$ 144,319
Unrealized Gains	28	45
Unrealized Losses	0	0
Aggregate Fair Value	$ 129,141	$ 144,364

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	$ 3,267	$ 3,005
Less: Accumulated depreciation	(1,627)	(1,434)
Property, Plant and Equipment, Net, Total	1,640	1,571
Tools and Equipment
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	2,010	2,173
Computer Equipment and Software
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	37	37
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	323	282
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	38	38
Construction In Process
Property Plant And Equipment [Line Items]
Property, Plant and Equipment, Gross	$ 859	$ 475

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Depreciation	$ 614	$ 710

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Accrued and Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accrued expenses	$ 1,639	$ 5,307
Current portion of lease liabilities	$ 573	$ 1,033
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accounts Payable and Other Accrued Liabilities, Current	Accounts Payable and Other Accrued Liabilities, Current
Short term interest payable	$ 375	$ 348
Other accrued liabilities	1,187	1,087
Total accrued and other current liabilities	$ 3,774	$ 7,775

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Other Noncurrent Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Long term interest payable	$ 1,524	$ 1,194
Noncurrent portion of lease liabilities	$ 914	$ 635
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Liabilities, Noncurrent, Total	Other Liabilities, Noncurrent, Total
Other noncurrent liabilities	$ 38	$ 38
Other Liabilities, Noncurrent, Total	$ 2,476	$ 1,867

Debt - Additional Information (

Debt - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Jan. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Long-term debt, net of current portion		$ 31,708	$ 33,313
MidCap Credit Facility Agreements [Member]
Debt Instrument [Line Items]
Long-term debt, net of current portion		$ 35,000
Long-Term Debt, Fixed Percentage Rate		6%
Mid Cap Financial Services
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 40,000
Interest expense, debt		$ 1,500	$ 1,200
Mid Cap Financial Services | Secured Overnight Financing Rate (SOFR) Overnight Index Swap Rate [Member]
Debt Instrument [Line Items]
Debt instrument, variable rate		7%
Mid Cap Financial Services | Senior Secured Two Thousand Nineteen Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 35,000
Mid Cap Financial Services | Revolving Credit Facility Two Thousand Nineteen
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 5,000
Subsequent Event [Member] | Hercules Credit Agreement [Member] | MidCap Credit Facility Agreements [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 65,000
Debt instrument, variable rate	10.35%
Debt instrument, frequency of periodic payment	30 months
Debt instrument interest payment extended term	36 months
Debt instrument, effective interest rate	2.35%
Interest Rate During Period	5.95%
Line Of Credit Facility Utilized to Pay	$ 35,000
Debt instrument, Initial interest rate	10.85%
Maturity Date	Jul. 01, 2028
Subsequent Event [Member] | Lenders [Member] | Hercules Credit Agreement [Member] | MidCap Credit Facility Agreements [Member]
Debt Instrument [Line Items]
Issue of warrants to purchase common stock	135,686
Class of warrant, exercise price	$ 5.159
Warrants expiration term	7 years

Debt - Schedule of Long-term an

Debt - Schedule of Long-term and Short-term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Principal payments due	$ 35,000	$ 35,000
Less: debt discount related to warrant liability and issuance costs	(1,073)	(1,687)
Total amounts outstanding	33,927	33,313
Less: Current portion, net of discount	2,219	0
Long-term debt	31,708	33,313
MidCap Term Loan [Member]
Debt Instrument [Line Items]
Principal payments due	$ 35,000	$ 35,000

Debt - Schedule Relating to the

Debt - Schedule Relating to the Company's Debt (Details) $ in Thousands	Dec. 31, 2023 USD ($)
Debt Disclosure [Abstract]
2024	$ (2,917)
2025	(32,083)
Thereafter	0
Total repayments	$ (35,000)

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Supply Commitment [Line Items]
Operating lease right-of-use assets	$ 1,458	$ 1,614
Remaining lease term	2 years 6 months
Operating leases, rent expense	$ 1,157	732
Supply agreement [Member]
Supply Commitment [Line Items]
Extending the lease term	26
Operating lease right-of-use assets	$ 1,200	$ 700
Lease, borrowing rate	11.40%	10.75%
Remaining lease term	34 months
Total base rent under lease agreement	$ 1,500	$ 700
Operating lease term	37 months	18 months

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Operating Lease Expense Recognized and Supplemental Cash Flow (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Operating lease expense	$ 1,157	$ 732
Cash paid for operating leases	1,158	731
New operating lease assets obtained in exchange for operating lease liabilities	$ 849	$ 660

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Aggregate Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
2024	$ 700
2025	548
2026	468
Total future minimum lease payments	1,716
Less: imputed interest	(229)
Present value of future minimum lease payments	$ 1,487
Operating Lease, Liability, Statement of Financial Position [Extensible Enumeration]	Present value of future minimum lease payments
Less: current portion of operating lease liability	$ (573)	$ (1,033)
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accounts Payable and Other Accrued Liabilities, Current	Accounts Payable and Other Accrued Liabilities, Current
Operating lease liabilities - noncurrent	$ 914	$ 635

Stockholders' Equity (Additiona

Stockholders' Equity (Additional Information) (Details)	12 Months Ended
	Dec. 31, 2023 USD ($) Vote $ / shares shares	Dec. 31, 2022 $ / shares shares
Subsidiary, Sale of Stock [Line Items]
Common stock, shares authorized | shares	200,000,000	200,000,000
Common stock, par value | $ / shares	$ 0.001	$ 0.001
Preferred stock, shares authorized | shares	10,000,000	10,000,000
Preferred stock par value | $ / shares	$ 0.001	$ 0.001
Dividends declared | $	$ 0
Number of votes entitled per share of common stock | Vote | Vote	1
IPO
Subsidiary, Sale of Stock [Line Items]
Common stock, shares authorized | shares	200,000,000
Common stock, par value | $ / shares	$ 0.001
Preferred stock, shares authorized | shares	10,000,000
Preferred stock par value | $ / shares	$ 0.001

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of Reserved Common Stock for Future Issuances (Details) - shares	Dec. 31, 2023	Dec. 31, 2022
Common Stock, Capital Shares Reserved for Future Issuance	15,222,954	13,159,736
Common stock options issued and outstanding
Common Stock, Capital Shares Reserved for Future Issuance	4,980,190	4,819,906
Common stock available for future grant
Common Stock, Capital Shares Reserved for Future Issuance	6,033,176	6,099,584
Restricted stock units outstanding
Common Stock, Capital Shares Reserved for Future Issuance	2,721,361	1,014,123
Shares available for future purchase under ESPP
Common Stock, Capital Shares Reserved for Future Issuance	1,488,227	1,226,123

Equity Incentive Plans - Additi

Equity Incentive Plans - Additional Details (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Jan. 01, 2023	Jan. 01, 2022	Jul. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Weighted-average grant-date fair values of options granted	$ 3.78	$ 9.56
Aggregate intrinsic value of options exercised	$ 1,700
Unrecognized stock-based compensation of unvested options	$ 14,100
Common stock reserved for future issuance	15,222,954	13,159,736
Description of transaction of future issuance	lesser of (i) 5% of the aggregate number of shares of common stock outstanding on the final day of the immediately preceding calendar year and (ii) such smaller number of shares of common stock as determined by the Board, subject to certain limitations.
Weighted-average period expected to recognize	1 year 9 months 18 days
Dividend yield	0%	0%
Stock based compensation	$ 8,500
Withholding taxes on net share settlement of restricted stock units	(224)
Stock Issued During Period, Value, Purchase of Assets	933	$ 672
Restricted Stock Units (RSUs)
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized stock-based compensation of unvested options	$ 16,200
Weighted-average period expected to recognize	2 years 10 months 24 days
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period	4 years
Stock based compensation	$ 5,500
Two Thousand And Twenty One Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for future issuance	5,200,000		2,414,907	2,375,235
Common stock available for issuance	6,033,176	6,099,584
Two Thousand Twenty One Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock reserved for future issuance	1,488,227	1,226,123	482,981	475,074	850,000
Dividend yield	0%	0%
Stock based compensation	$ 600
Proceeds from stock plans	$ 100
Stock Issued During Period, Shares, Purchase of Assets	220,877
Stock Issued During Period, Value, Purchase of Assets	$ 900

Equity Incentive Plans - Summar

Equity Incentive Plans - Summary of Company stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-Based Payment Arrangement [Abstract]
Number of Shares	4,819,906
Number of Shares, Granted	1,360,308
Number of Shares, Forfeited/cancelled	(829,897)
Number of Shares, Exercised	(370,127)
Number of Shares	4,980,190	4,819,906
Vested and exercisable as of December 31, 2023	2,670,019
Vested and expected to vest as of December 31, 2023	4,980,190
Weighted-Average Exercise Price	$ 9.67
Weighted-Average Exercise Price, Grants	6.37
Weighted-Average Exercise Price, Forfeited/cancelled	12.18
Weighted-Average Exercise Price, Exercised	1.03
Weighted-Average Exercise Price	9	$ 9.67
Weighted-Average Exercise Price, Vested and exercisable	8.62
Weighted-Average Exercise Price, Expected to vest	$ 9
Weighted Average Remaining Contractual Term	7 years 4 months 24 days	7 years 8 months 12 days
Weighted average contractual term, vested and exercisable	6 years 4 months 24 days
Weighted average contractual term, vested and expected	7 years 4 months 24 days
Average Intrinsic Value	$ 19,463
Average Intrinsic Value	5,924	$ 19,463
Average Intrinsic Value, Vested and exercisable as of December 31, 2023	3,797
Average Intrinsic Value, Vested and expected to vest as of December 31, 2023	$ 5,924

Equity Incentive Plans - Summ_2

Equity Incentive Plans - Summary of Stock Based Compensation Fair Value Assumptions (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Dividend yield	0%	0%
Two Thousand Twenty One Employee Stock Purchase Plan [ Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Dividend yield	0%	0%
Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	5 years 7 months 6 days	5 years 4 months 17 days
Expected volatility	60.72%	58.74%
Risk-free interest rate	3.07%	1.35%
Minimum [Member] | Two Thousand Twenty One Employee Stock Purchase Plan [ Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	5 months 23 days	5 months 23 days
Expected volatility	66.72%	76.50%
Risk-free interest rate	4.62%	1.51%
Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	6 years 25 days	6 years 11 months 12 days
Expected volatility	61.80%	64.97%
Risk-free interest rate	4.35%	3.97%
Maximum [Member] | Two Thousand Twenty One Employee Stock Purchase Plan [ Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	6 months	6 months
Expected volatility	197.51%	97.38%
Risk-free interest rate	5.40%	4.62%

Equity Incentive plans - Summ_3

Equity Incentive plans - Summary of restricted share award activity (Details) - Restricted Stock Units (RSUs)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Number of shares | shares	1,014,123
Number of shares, Grants | shares	2,392,662
Number of shares, Forfeited/cancelled | shares	(441,759)
Number of shares, Vested | shares	(243,665)
Number of shares | shares	2,721,361
Weighted Average Grant Date Fair Value, Beginning Balance | $ / shares	$ 14.25
Weighted Average Grant Date Fair Value, Grants | $ / shares	6.28
Weighted Average Grant Date Fair Value, Forfeited/cancelled | $ / shares	12.14
Weighted Average Grant Date Fair Value, Vested | $ / shares	13.96
Weighted Average Grant Date Fair Value, Ending Balance | $ / shares	$ 7.61

Equity Incentive Plans - Summ_4

Equity Incentive Plans - Summary of Share-Based Compensation Expense By Function (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 14,581	$ 12,963
Cost of goods sold
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	289	167
Research and Development Expense
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	2,111	1,315
Selling, General and Administrative Expenses
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 12,181	$ 11,481

Net Loss per Share Attributab_3

Net Loss per Share Attributable to Common Stockholders - Schedule of Computation of Basic and Diluted Net Loss per Share Attributable to Common Stockholders (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Numerator:
Net Income (Loss)	$ (55,547)	$ (86,242)
Denominator:
Weighted-average shares of common stock outstanding-basic	48,628,940	47,849,058
Weighted-average shares of common stock outstanding-diluted	48,628,940	47,849,058
Net loss per share attributable to common stockholders-basic	$ (1.14)	$ (1.8)
Net loss per share attributable to common stockholders-diluted	$ (1.14)	$ (1.8)

Net Loss per Share Attributab_4

Net Loss per Share Attributable to Common Stockholders - Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Redeemable convertible preferred stock	7,701,551	5,834,029
Restricted Stock Units (RSUs)
Redeemable convertible preferred stock	2,721,361	1,014,123
Employee Stock Option
Redeemable convertible preferred stock	4,980,190	4,819,906

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax Provision (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Federal	$ 0	$ 0
Foreign	110	47
State	0	0
Provision (benefit) for income taxes	$ 110	$ 47

Income Taxes - Schedule of Tax

Income Taxes - Schedule of Tax Effects of Temporary Differences and Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred tax assets:
Net operating loss carryforwards	$ 60,753	$ 52,616
Deferred compensation	5,547	3,974
Research and development expenses	4,566	1,743
Research and development credits	2,357	1,918
Disallowed interest expense carryover	830	444
Operating lease liability	388	436
Provision for bad debt	310	398
Other	285	144
Gross deferred tax assets	75,036	61,673
Less: Valuation allowance	(74,655)	(61,251)
Deferred tax assets, net of valuation allowance	381	422
Operating lease right-of-use assets	(381)	(422)
Deferred tax liabilities:	(381)	(422)
Net deferred tax assets	$ 0	$ 0

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Details)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Tax at statutory federal rate	21%	21%
State tax, net of federal benefit	5%	5%
Research and development credit	2%	1%
Change in valuation allowance	(25.00%)	(26.00%)
Other	(3.00%)	(1.00%)
Effective tax rate	0%	0%

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Operating Loss Carryforwards [Line Items]
Unrecognized Tax Benefits	$ 900	$ 700
Research and development credits	2,357	1,918
Remaining operating loss carried forward	$ 220,700
Taxable income limitation	80%
Income/(loss) Domestic	$ 55,700	86,000
Income (Loss) Foreign	200	200
Interest expense carryforwards	800	400
Domestic Tax Authority
Operating Loss Carryforwards [Line Items]
Operating Loss Carryforwards	235,500	204,600
Research and development credits	1,900	1,500
State and Local Jurisdiction
Operating Loss Carryforwards [Line Items]
Operating Loss Carryforwards	201,600	187,500
Research and development credits	$ 1,700	1,500
Federal And State
Operating Loss Carryforwards [Line Items]
Operating Loss Carryforwards		$ 14,800
Federal and certain state net operating losses expire date, Description	The pre-2018 federal and certain state net operating losses will begin to expire in 2031 and 2032, respectively, if not utilized

Income Taxes - Schedule of Unre

Income Taxes - Schedule of Unrecognized Tax Benefits Roll Forward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Unrecognized tax benefits at the beginning of the year	$ 741	$ 580
Additions based on tax positions related to the current year	162	161
Additions for tax positions of prior years	0	0
Unrecognized tax benefits at the end of the year	$ 903	$ 741

Segment Information - Additiona

Segment Information - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023 Segment
Segment Reporting [Abstract]
Number of Reportable Segments	2

Segment Information - Summary o

Segment Information - Summary of Operating Result Information for Each Reportable Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Revenue
Revenue	$ 81,056	$ 71,331
Cost of goods sold
Cost of goods sold	11,881	12,361
Gross profit
Gross profit	69,175	58,970
OperatingExpenses	126,449	142,924
Loss from operations	(57,274)	(83,954)
Interest expense	(5,408)	(4,466)
Other income (expense), net	7,245	2,225
Loss before income taxes	(55,437)	(86,195)
Surgical Glaucoma
Revenue
Revenue	74,310	65,594
Cost of goods sold
Cost of goods sold	8,830	8,295
Gross profit
Gross profit	65,480	57,299
Dry Eye
Revenue
Revenue	6,746	5,737
Cost of goods sold
Cost of goods sold	3,051	4,066
Gross profit
Gross profit	$ 3,695	$ 1,671

Subsequent Events (Additional I

Subsequent Events (Additional Information) (Details) - Subsequent Event [Member] - Hercules Capital Inc [Member] - Line of Credit [Member] $ in Millions	1 Months Ended
	Jan. 31, 2024 USD ($)
Subsequent Event [Line Items]
Maximum borrowing capacity	$ 65
Initial Borrowing Capacity	$ 35
Maturity Date	Jul. 01, 2028
Debt instrument, Initial interest rate	10.85%
Maximum [Member]
Subsequent Event [Line Items]
Debt instrument interest payment term	36 months
Debt instrument, variable rate	10.35%
Minimum [Member]
Subsequent Event [Line Items]
Debt instrument interest payment term	30 months
Debt instrument, variable rate	2.35%