Sight Sciences (SGHT) 10-Q 7 Nov 24 2024 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2024	Nov. 01, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Current Fiscal Year End Date	--12-31
Entity Registrant Name	SIGHT SCIENCES, INC.
Entity Central Index Key	0001531177
Securities Act File Number	001-40587
Entity Incorporation, State or Country Code	DE
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
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	SGHT
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Security Exchange Name	NASDAQ
Entity Filer Category	Non-accelerated Filer
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Entity Small Business	true
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		50,754,616

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 118,564	$ 138,129
Accounts receivable, net of allowance for credit losses of $824 and $1,186 at September 30, 2024 and December 31, 2023, respectively	12,929	14,289
Inventory, net	6,091	7,849
Prepaid expenses and other current assets	2,885	2,604
Total current assets	140,469	162,871
Property and equipment, net	1,448	1,640
Operating lease right-of-use assets	1,100	1,458
Other noncurrent assets	580	682
Total assets	143,597	166,651
Current liabilities:
Accounts payable	1,297	1,731
Accrued compensation	7,889	4,528
Accrued and other current liabilities	4,613	3,774
Current portion - long-term debt, net	0	2,219
Total current liabilities	13,799	12,252
Long-term debt, net	34,152	31,708
Other noncurrent liabilities	689	2,476
Total liabilities	48,640	46,436
Commitments and contingencies (Note 6)
Stockholders' equity:
Preferred stock, par value $0.001 per share; 10,000,000 shares authorized; no shares issued and outstanding as of September 30, 2024 and December 31, 2023	0	0
Common stock, par value $0.001 per share; 200,000,000 shares authorized; 50,398,148 and 49,131,363 shares issued and outstanding as of September 30, 2024 and December 31, 2023, respectively	50	49
Additional paid-in-capital	429,358	414,956
Accumulated deficit	(334,451)	(294,790)
Total stockholders' equity	94,957	120,215
Total liabilities and stockholders' equity	$ 143,597	$ 166,651

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Accounts receivable, net of allowance for credit losses	$ 824	$ 1,186
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	50,398,148	49,131,363
Common stock, shares outstanding	50,398,148	49,131,363

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss (Unaudited) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Revenue	$ 20,157	$ 20,009	$ 60,792	$ 62,305
Cost of goods sold	3,250	2,677	9,068	9,105
Gross profit	16,907	17,332	51,724	53,200
Operating expenses:
Research and development	4,746	4,239	13,698	14,129
Selling, general and administrative	23,390	26,504	76,629	85,235
Total operating expenses	28,136	30,743	90,327	99,364
Loss from operations	(11,229)	(13,411)	(38,603)	(46,164)
Investment income	1,454	1,897	4,628	5,499
Interest expense	(1,151)	(1,432)	(3,501)	(4,057)
Loss on debt extinguishment	0	0	(1,962)	0
Other income (expense), net	26	(11)	(25)	(34)
Loss before income taxes	(10,900)	(12,957)	(39,463)	(44,756)
Provision for income taxes	166	78	198	100
Net loss and comprehensive loss	$ (11,066)	$ (13,035)	$ (39,661)	$ (44,856)
Net loss per share attributable to common stockholders-basic	$ (0.22)	$ (0.27)	$ (0.79)	$ (0.92)
Net loss per share attributable to common stockholders-diluted	$ (0.22)	$ (0.27)	$ (0.79)	$ (0.92)
Weighted-average shares used in computing net loss per share attributable to common stockholders-basic	50,340,603	48,671,049	49,911,655	48,538,517
Weighted-average shares used in computing net loss per share attributable to common stockholders-diluted	50,340,603	48,671,049	49,911,655	48,538,517

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Redeemable Convertible Preferred Stock and Stockholders' Equity (Unaudited) - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Deficit
Beginning Balance at Dec. 31, 2022	$ 160,076	$ 48	$ 399,271	$ (239,243)
Beginning Balance, shares at Dec. 31, 2022		48,298,138
Issuance of common stock upon exercise of stock options		163,940
Issuance of common stock upon exercise of stock options	288		288
Issuance of common stock upon vesting of restricted stock units	1	$ 1
Issuance of common stock upon vesting of restricted stock units, shares		181,607
Withholding taxes on net share settlement of restricted stock units	(222)		(222)
ESPP purchase	661		661
ESPP purchase, Shares		78,534
Stock-based compensation expense	11,121		11,121
Net Income (Loss)	(44,856)			(44,856)
Ending Balance at Sep. 30, 2023	127,069	$ 49	411,119	(284,099)
Ending Balance, shares at Sep. 30, 2023		48,722,219
Beginning Balance at Jun. 30, 2023	136,131	$ 49	407,146	(271,064)
Beginning Balance, shares at Jun. 30, 2023		48,649,343
Issuance of common stock upon exercise of stock options		60,738
Issuance of common stock upon exercise of stock options	117		117
Issuance of common stock upon vesting of restricted stock units	0	$ 0
Issuance of common stock upon vesting of restricted stock units, shares		12,138
Stock-based compensation expense	3,856		3,856
Net Income (Loss)	(13,035)			(13,035)
Ending Balance at Sep. 30, 2023	127,069	$ 49	411,119	(284,099)
Ending Balance, shares at Sep. 30, 2023		48,722,219
Beginning Balance at Dec. 31, 2023	120,215	$ 49	414,956	(294,790)
Beginning Balance, shares at Dec. 31, 2023		49,131,363
Issuance of common stock upon exercise of stock options		194,119
Issuance of common stock upon exercise of stock options	233		233
Issuance of common stock upon vesting of restricted stock units		$ 1	(1)
Issuance of common stock upon vesting of restricted stock units, shares		840,376
Warrant issuance	609		609
Withholding taxes on net share settlement of restricted stock units	(20)		(20)
ESPP purchase	450		450
ESPP purchase, Shares		232,290
Stock-based compensation expense	13,131		13,131
Net Income (Loss)	(39,661)			(39,661)
Ending Balance at Sep. 30, 2024	94,957	$ 50	429,358	(334,451)
Ending Balance, shares at Sep. 30, 2024		50,398,148
Beginning Balance at Jun. 30, 2024	101,638	$ 50	424,973	(323,385)
Beginning Balance, shares at Jun. 30, 2024		50,136,131
Issuance of common stock upon exercise of stock options		38,936
Issuance of common stock upon exercise of stock options	77		77
Issuance of common stock upon vesting of restricted stock units, shares		223,081
Stock-based compensation expense	4,308		4,308
Net Income (Loss)	(11,066)			(11,066)
Ending Balance at Sep. 30, 2024	$ 94,957	$ 50	$ 429,358	$ (334,451)
Ending Balance, shares at Sep. 30, 2024		50,398,148

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities
Net loss	$ (39,661)	$ (44,856)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	536	455
Accretion of debt discount and debt issuance costs	550	452
Stock-based compensation expense	13,131	11,121
Allowance for credit losses	(68)	416
Provision (benefit) for excess and obsolete inventories	(105)	219
Noncash operating lease expense	481	743
Loss on disposal of property and equipment	23	66
Noncash loss on debt extinguishment	1,033	0
Changes in operating assets and liabilities:
Accounts receivable	1,427	(2,187)
Inventory	1,863	(3,345)
Prepaid expenses and other current assets	(280)	517
Other noncurrent assets	(35)	(444)
Accounts payable	(41)	841
Accrued compensation	3,360	(1,851)
Accrued and other current liabilities	418	(3,089)
Other noncurrent liabilities	(1,524)	242
Net cash used in operating activities	(18,892)	(40,700)
Cash flows from investing activities
Purchases of property and equipment	(248)	(527)
Net cash used in investing activities	(248)	(527)
Cash flows from financing activities
Net proceeds from Hercules Loan Agreement	34,526	0
Repayment of MidCap Loan Agreement	(35,375)	0
Debt issuance costs	(238)	0
Proceeds from employee stock purchase plan purchases	450	289
Taxes paid on net share settlement of restricted stock units	(20)	(222)
Proceeds from exercise of common stock options	232	661
Net cash (used in) provided by financing activities	(425)	728
Net change in cash and cash equivalents	(19,565)	(40,499)
Cash and cash equivalents at beginning of period	138,129	185,000
Cash and cash equivalents at end of period	118,564	144,501
Supplemental disclosure of cash flow information
Cash paid for interest	3,023	3,167
Supplemental noncash disclosure of investing and financing activities
Acquisition of property and equipment included in accounts payable and accrued liabilities	43	81
Common stock warrants issued upon execution of Hercules Loan Agreement	$ 609	$ 0

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (11,066)	$ (13,035)	$ (39,661)	$ (44,856)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024 shares
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	Trading Plans Our directors and officers may enter into trading plans or other arrangements with financial institutions to purchase or sell shares of our common stock, which plans or arrangements are intended to comply with the affirmative defense provisions of Rule 10b5-1 of the Exchange Act or which may represent a non-Rule 10b5-1 trading arrangement as defined under Item 408(a) of Regulation S-K. Set forth below is a summary of the adoption , modification , and termination activity of our directors and executive officers in respect of their Rule 10b5-1 trading plans during the quarter ended September 30, 2024: Name & Title Adoption Date Termination Date Contract End Date Aggregate Shares Covered (in ones) Jeremy B. Hayden , Chief Legal Officer August 28, 2024 August 25, 2025 August 25, 2025 48,000
Jeremy B. Hayden [Member]
Trading Arrangements, by Individual
Name	Jeremy B. Hayden
Title	Chief Legal Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	August 28, 2024
Rule 10b5-1 Arrangement Terminated	true
Termination Date	August 25, 2025
Expiration Date	August 25, 2025
Aggregate Available	48,000
Rule 10b5-1 Arrangement Modified	true

Company and Nature of Business

Company and Nature of Business	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Company and Nature of Business	Note 1. 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 mission is to develop transformative, interventional technologies that allow eyecare providers to procedurally elevate the standards of care — empowering people to keep seeing. 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, handheld, single-use, therapeutic technology that enables ophthalmic surgeons to perform a comprehensive procedure (i) indicated in the United States to reduce intraocular pressure in adult patients with primary open-angle glaucoma, and (ii) CE Marked for the catheterization and transluminal viscodilation of Schlemm’s canal and cutting of the trabecular meshwork to reduce intraocular pressure in adult patients with open-angle glaucoma; and the SION® Surgical Instrument ("SION"), a bladeless, 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 proprietary, interventional, dry eye device designed to melt and facilitate the comprehensive removal of meibomian gland obstructions and restore gland functionality and healthy oil production for adult patients with evaporative dry eye disease due to meibomian gland dysfunction (“MGD”) 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 September 30, 2024, the Company had an accumulated deficit of $ 334.5 million since inception and recorded a net loss of $ 39.7 million for the nine months 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 unaudited condensed consolidated 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	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies Basis of Presentation The condensed consolidated financial statements and accompanying notes thereto are unaudited and have been prepared in accordance with accounting principles generally accepted in the United States of America ("US GAAP") applicable to interim periods and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. The Company’s condensed 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. The unaudited condensed consolidated financial statements have been prepared on a basis consistent with the audited consolidated financial statements. In the opinion of management, the unaudited condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments, necessary for the fair presentation of the Company's financial information contained herein. The condensed consolidated balance sheet as of December 31, 2023 is derived from the Company's consolidated audited financial statements as of that date. These interim condensed consolidated financial statements do not include all disclosures required by US GAAP and should be read in conjunction with the Company's audited consolidated financial statements and the accompanying notes thereto for the fiscal year ended December 31, 2023, which are contained in the Annual Report. The Company's results of operations for the nine months ended September 30, 2024 are not necessarily indicative of the results to be expected for the year ending December 31, 2024 or for any other interim period. Use of Estimates The preparation of the unaudited condensed consolidated 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, 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. New Accounting Pronouncements Accounting Standards Recently Adopted During the nine-month period ended September 30, 2024, there were no significant Accounting Standard Updates ("ASUs") issued that were adopted. Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. 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 on a retrospective basis for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, 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 September 30, 2024, 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	9 Months Ended
	Sep. 30, 2024
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 $ 100.5 million and $ 129.1 million as of September 30, 2024 and December 31, 2023, 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. September 30, 2024 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. treasury securities $ 100,488 $ 24 $ ( 1 ) $ 100,511 December 31, 2023 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. treasury securities $ 129,113 $ 28 $ — $ 129,141 The Company measures the fair value of outstanding debt for disclosure purposes on a recurring basis. As of September 30, 2024 and December 31, 2023, total debt of $ 34.2 million and $ 33.9 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 Company measures the fair value of the unissued common stock warrants to be issued pursuant to the Hercules Loan Agreement (as defined in Note 5, Debt) using the Black-Scholes option pricing method. These are classified as Level 3 liabilities, with an overall value of less than $ 0.1 million as of September 30, 2024. The unissued warrants are remeasured at each reporting date following execution of the Hercules Loan Agreement. See Note 5, Debt, and Note 7, Stockholders' Equity, for additional information regarding the common stock warrants. The financial statements as of September 30, 2024 and December 31, 2023 do not include any assets or liabilities that are measured at fair value on a nonrecurring basis.

Balance Sheet Components

Balance Sheet Components	9 Months Ended
	Sep. 30, 2024
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 September 30, As of December 31, 2024 2023 Tools and equipment $ 1,991 $ 2,010 Computer equipment and software 37 37 Furniture and fixtures 286 323 Leasehold improvements 38 38 Construction in process 1,071 859 3,423 3,267 Less: Accumulated depreciation ( 1,975 ) ( 1,627 ) Property and equipment, net $ 1,448 $ 1,640 Depreciation expense was $ 0.1 million and $ 0.4 million for the three and nine months ended September 30, 2024, respectively. Depreciation expense was $ 0.2 million and $ 0.5 million for the three and nine months ended September 30, 2023, respectively. Accrued and Other Current Liabilities Accrued and other current liabilities consist of the following (in thousands): As of September 30, As of December 31, 2024 2023 Accrued expenses $ 2,447 $ 1,639 Current portion of lease liabilities 519 573 Short-term interest payable 311 375 Other accrued liabilities 1,336 1,187 Total accrued and other current liabilities $ 4,613 $ 3,774 Other Noncurrent Liabilities Other noncurrent liabilities consist of the following (in thousands): As of September 30, As of December 31, 2024 2023 Noncurrent portion of lease liabilities $ 614 $ 914 Other noncurrent liabilities 75 38 Long-term interest payable — 1,524 Total other noncurrent liabilities $ 689 $ 2,476

Debt

Debt	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Debt	Note 5. Debt Hercules Capital Loan Agreement In January 2024, the Company entered into a Loan and Security Agreement (the “Hercules Loan Agreement”), with Hercules Capital, Inc. (“Hercules”) and certain of its affiliates (collective with Hercules, the “Lenders”), which provides for a senior secured term loan facility in the aggregate principal amount of up to $ 65.0 million. An initial tranche of $ 35.0 million (the “Initial Loan”) was funded under the Hercules Loan Agreement on January 22, 2024. In addition to the Initial Loan, the Hercules Loan Agreement provides for additional tranches as follows: $ 5.0 million available in a single draw through December 15, 2024, $ 10.0 million available to draw upon the achievement of certain performance milestones through September 15, 2025, and $ 15.0 million available for the Company to draw on through the interest-only period in increments of $ 5.0 million, subject to the sole approval of Hercules' investment committee (such tranche loans together with the Initial Loan, the “Term Loans”). The Hercules Loan Agreement includes a maturity date of July 1, 2028 , with an interest only period running for the first 30 months of the agreement term, extendable for an additional six months for a total of 36 months upon the achievement of certain milestones. The Term Loans accrue interest at a floating annual rate of the greater of 10.35 % or the Wall Street Journal prime rate plus 2.35 %, with the interest rate under the Term Loans equal to 10.35 % at September 30, 2024. The final payment fee is set at 5.95 % of the funded balance, which is recognized as a debt discount and is being accreted into the amortization of debt issuance costs using the effective interest rate method over the term of the loan. In conjunction with the funding of the Initial Loan, the Company issued warrants to the Lenders to purchase up to an aggregate of 135,686 shares of its common stock at an exercise price of $ 5.159 per share, which were recorded and classified as equity. Each warrant is exercisable for a period of seven years from the date of issuance. See Note 7, Stockholders' Equity, for additional information regarding these common stock warrants. The obligations under the Hercules Loan Agreement are guaranteed by the Company and its future subsidiaries, subject to exceptions for certain foreign subsidiaries. The obligations under the agreement are secured by substantially all of the Company's assets, including its material intellectual property. Additionally, the Company is subject to customary affirmative and negative covenants, including covenants that limit or restrict the ability of the Company 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. The Company is also subject to certain minimum cash and revenue covenants under the Hercules Loan Agreement. The Company was in compliance with all covenants as of September 30, 2024. MidCap Loan Agreement The Company had credit and security agreements with certain entities affiliated with MidCap Financial Services (such entities collectively, “MidCap”), which provided for a $ 35.0 million senior secured term loan (the “MidCap Term Loan”). In January 2024, the Company terminated the Amended and Restated Credit and Security Agreement (Term Loan) (the “MidCap Term Loan Agreement”) evidencing the MidCap Term Loan and paid off in full the secured obligations thereunder in connection with its entry into the Hercules Loan Agreement. The Company recorded a loss on debt extinguishment of $ 2.0 million during the nine months ended September 30, 2024. The commitment obligations under 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. 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. In addition, 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 MidCap Term Loan balance, which was recorded as a long-term interest payable as of December 31, 2023. Maturities Schedule Long-term and short-term debt as of September 30, 2024 and December 31, 2023, respectively, was as follows (in thousands): As of September 30, As of December 31, 2024 2023 Hercules Initial Loan $ 35,000 $ — MidCap Term Loan — 35,000 Total principal payments due 35,000 35,000 Less: unamortized discount and debt issuance costs ( 848 ) ( 1,073 ) Total amounts outstanding 34,152 33,927 Less: current portion — ( 2,219 ) Long-term debt, net $ 34,152 $ 31,708 The repayment schedule relating to the Hercules Initial Loan as of September 30, 2024, is as follows (in thousands): Amount 2024 (remainder) $ — 2025 — 2026 6,680 2027 17,294 Thereafter 11,026 Total principal payments $ 35,000 Final fee due at maturity 2,083 Total repayments $ 37,083

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 6. Commitments and Contingencies Operating Lease Obligations The Company’s leases include facility leases and equipment 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 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 was expected to last approximately 18 months. In January 2024, the term was extended through December 31, 2024. 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 $ 0.2 million and $ 0.3 million for the three months ended September 30, 2024 and 2023, respectively. The Company’s rent expense was $ 0.6 million and $ 0.9 million for the nine months ended September 30, 2024 and 2023, respectively. As of September 30, 2024, the weighted average remaining lease term for the leases was 2.0 years. Operating lease expense and supplemental cash flow information related to operating leases for the three months ended September 30, 2024 and 2023 were as follows (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Operating lease expense $ 196 $ 288 $ 587 $ 869 Cash paid for operating leases 162 295 582 885 Aggregate future minimum lease payments as of September 30, 2024, under these noncancelable operating leases were as follows (in thousands): As of September 30, 2024 2024 (remainder) $ 158 2025 618 2026 497 Total future minimum lease payments $ 1,273 Less: imputed interest ( 140 ) Present value of future minimum lease payments $ 1,133 Less: current portion of operating lease liability ( 519 ) Noncurrent portion of lease liabilities $ 614 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) (the “Court”) alleging that Ivantis, Inc. (“Ivantis”) directly and indirectly infringes the Company’s 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 (collectively, “Alcon”) 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 asserted counterclaims requesting declaratory judgments that the Company’s asserted patents-in-suit are not infringed and/or are invalid. In September 2022, 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 U.S. Patent Office. On April 26, 2024, at the conclusion of a five-day jury trial, the Company was awarded a positive jury trial verdict of $34 million, comprised of $5.5 million in lost profits damages and $28.5 million in royalty damages for commercial sales of the Hydrus Microstent for the period between its commercial launch through trial. The patents at issue were U.S. Patent Nos. 8,287,482, 9,370,443, and 11,389,328. The parties have submitted their post-trial briefings and the Court will hold an in-person hearing in December 2024 to hear the parties’ oral arguments on these briefings. The Court will enter its final judgement after the hearing, with such entry currently expected in late fourth quarter 2024 or in first quarter 2025. The Court's final judgment will be subject to appeal. 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. In addition to the foregoing, from time to time, the Company is subject to legal claims, regulatory matters and contingencies in the ordinary course of business. Accruals for these matters are reflected in the financial statements based on management’s assessment, including the advice of legal counsel, of the expected outcome of these matters. Liabilities for estimated losses are accrued if the potential losses from any legal proceedings, regulatory matters or contingencies 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 legal claims, regulatory matters and contingencies, and may revise its previous estimates, which could materially affect the Company’s results of operations in a given period. Except as described above, as of September 30, 2024 and December 31, 2023, the Company was not a party to any legal proceedings, regulatory matters, or other disputes or claims which, if determined adversely, would, individually or taken together, have a material adverse effect on the Company’s business, financial condition, operating results, liquidity, or future prospects. 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 or officer may be subject to any proceeding arising out of acts or omissions of such director or officer in such capacity. The maximum amount of potential future indemnification is unlimited; however, the Company currently holds director and officer 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 the fair value of these indemnification obligations is minimal. Accordingly, the Company has not recognized any liabilities relating to these obligations as of September 30, 2024 and December 31, 2023.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Stockholders' 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 September 30, 2024, no dividends have been declared. Each share of common stock is entitled to one vote. At September 30, 2024 and December 31, 2023, the Company had reserved common stock for future issuances as follows: September 30, December 31, 2024 2023 Common stock available for future grants 5,956,636 6,033,176 Common stock options issued and outstanding 4,583,289 4,980,190 Restricted stock units outstanding 4,574,045 2,721,361 Shares available for future purchase under employee stock purchase plan 1,747,250 1,488,227 Total 16,861,220 15,222,954 Common Stock Warrants In conjunction with the funding of the Initial Loan under the Hercules Loan Agreement, the Company issued common stock warrants to the Lenders to purchase up to an aggregate of 135,686 shares of our common stock at an exercise price of $ 5.159 per share. Each warrant is exercisable for up to seven years from the date of issuance. The warrants are classified as equity. During the nine months ended September 30, 2024, the fair value of the issued warrants recorded was $ 0.6 million, which was calculated using the Black-Scholes option pricing model. These warrants were recorded at fair value upon their issuance in additional paid-in capital in the condensed consolidated balance sheet. The issued warrants are not remeasured after the issuance date. If the additional Term Loans are funded, the Company will be obligated to issue to the Lenders additional warrants to purchase common stock in an amount equal to 2.0 % of the funded balance of each tranche, divided by the exercise price on the date the Company draws funds from such tranche, or the issuance date. The exercise price will be calculated using the five-day volume-weighted average stock price as of such date. The unissued warrants do not meet the requirements for classification in equity, and are recorded as liabilities in other noncurrent liabilities in the financial statements. The fair value of the unissued common stock warrants was calculated using the Black-Scholes option pricing method and they were recorded at fair value upon the funding of the Hercules Loan Agreement. The unissued warrants are remeasured at each reporting date after the issuance date. According to the fair value measurement criteria, the unissued warrants are considered Level 3 liabilities, with an overall value of less than $ 0.1 million as of September 30, 2024.

Equity Incentive Plans

Equity Incentive Plans	9 Months Ended
	Sep. 30, 2024
Share-Based Payment Arrangement [Abstract]
Equity Incentive Plans	Note 8. Equity Incentive Plans 2011 Stock Option Plan and 2021 Incentive Award 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 (either in annual or quarterly installments). 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 2,456,568 shares and 2,414,907 shares on January 1, 2024 and 2023, respectively. The 2011 Plan was superseded by the 2021 Plan at the time of the initial public offering of the Company's common stock, which closed on July 15, 2021, 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. As of September 30, 2024 and December 31, 2023 there were 5,956,636 shares and 6,033,176 shares, respectively, of common stock available for issuance under the 2021 Plan. Stock Option Awards The following table summarizes stock option activity under the 2021 Plan during the periods presented: Number of Weighted-Average Exercise Price Weighted-Average Average Intrinsic Value Balances as of December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924 Grants 7,377 4.43 Forfeited/cancelled ( 210,159 ) 10.15 Exercised/released ( 194,119 ) 1.20 Balances as of September 30, 2024 4,583,289 $ 9.28 7.0 $ 6,558 Vested and exercisable as of September 30, 2024 3,163,058 $ 9.32 6.4 $ 4,635 Vested and expected to vest as of September 30, 2024 4,583,289 $ 9.28 7.0 $ 6,558 During the three months ended September 30, 2024 and 2023, the Company recorded stock-based compensation expense of $ 1.9 million and $ 2.1 million related to stock option awards, respectively. During the nine months ended September 30, 2024 and 2023, the Company recorded stock-based compensation expense of $ 5.7 million and $ 6.6 million related to stock option awards, respectively. The weighted-average grant-date fair values of options granted during the nine months ended September 30, 2024 and 2023 was $ 2.71 and $ 6.92 per share, respectively. The aggregate intrinsic value of options exercised was $ 0.2 million and $ 0.8 million during the three and nine months ended September 30, 2024, respectively. 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. As of September 30, 2024, the unrecognized stock-based compensation expense relating to unvested opti ons was $ 8.1 million, which is expected to be recognized over a weighted-average period of 1.3 years. Determination of Fair Value The Company estimated the grant date fair value of stock options using the Black-Scholes option-pricing model, which requires the use of highly subjective and complex valuation assumptions to determine the fair value of stock-based awards, including the option’s expected term, the expected volatility of the underlying stock, the risk-free interest rate, and the expected dividend yield. For the purposes of the Black-Scholes valuation model, the Company used the simplified method for determining the expected term of the granted options. The simplified method was used since the Company does not have adequate historical data to utilize in calculating the expected term of options. The fair value for options granted was calculated using the following weighted average assumptions: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Expected term (in years) N/A 5.99 – 6.01 6.13 5.60 – 6.07 Expected volatility N/A 79.82 % 61.67 % 78.53 % – 79.82 % Risk-free interest rate N/A 4.04 % 4.28 % 3.48 % – 4.04 % Dividend yield N/A – – – 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 either (i) annually over a four-year period with straight-line vesting in equal amounts, or (ii) quarterly over a four-year period with straight-line vesting in equal amounts, in each case provided the holder provides continuous services to 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, 2023 2,721,361 $ 7.61 Grants 2,949,065 4.46 Forfeited/cancelled ( 213,175 ) 6.54 Vested ( 883,206 ) 7.58 Outstanding, September 30, 2024 4,574,045 $ 5.62 During the three months ended September 30, 2024 and 2023, the Company recorded stock-based compensation expense of $ 2.2 million and $ 1.6 million, respectively, related to the RSUs. During the nine months ended September 30, 2024 and 2023, the Company recorded stock-based compensation expense of $ 6.9 million and $ 4.2 million, respectively, related to the RSUs. As of September 30, 2024, there was $ 21.2 million of total unrecognized stock-based compensation expense relating to the RSUs that is expected to be recognized over a weighted-average period of 2.7 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 491,313 and 482,981 shares on January 1, 2024 and 2023, 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. During the nine months ended, September 30, 2024, participants in the ESPP purchased 232,290 shares for a total of $ 0.5 million. As of September 30, 2024, the Company has collected payroll withholdings of $ 0.4 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 $ 0.1 million for both the three months ended September 30, 2024 and 2023. The Company recorded stock-based compensation expense associated with the ESPP of $ 0.5 million and $ 0.4 million for the nine months ended September 30, 2024 and 2023, respectively. As of September 30, 2024, there were 1,747,250 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 three and nine months ended September 30, 2024 and 2023: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Expected term (in years) 0.49 – 0.50 0.48 – 0.50 0.49 – 0.50 0.48 – 0.50 Expected volatility 100.00 % – 197.51 % 66.72 % – 97.38 % 100.00 % – 197.51 % 66.72 % – 97.38 % Risk-free interest rate 5.37 % – 5.40 % 4.62 % – 5.32 % 5.37 % – 5.40 % 4.62 % – 5.32 % Dividend yield – – – – Stock-Based Compensation The following is a summary of stock-based compensation expense by function (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Cost of goods sold $ 83 $ 77 $ 283 $ 206 Research and development 588 549 1,787 1,664 Selling, general and administrative 3,637 3,230 11,061 9,251 Total stock-based compensation expense $ 4,308 $ 3,856 $ 13,131 $ 11,121

Net Loss per Share Attributable

Net Loss per Share Attributable to Common Stockholders	9 Months Ended
	Sep. 30, 2024
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 three and nine months ended September 30, 2024 and 2023, basic net loss per share is the same as diluted net loss per share for each of the reported periods. The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders for the periods presented (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Numerator: Net loss attributable to common stockholders $ ( 11,066 ) $ ( 13,035 ) $ ( 39,661 ) $ ( 44,856 ) Denominator: Weighted-average shares of common stock 50,340,603 48,671,049 49,911,655 48,538,517 Net loss per share attributable to common $ ( 0.22 ) $ ( 0.27 ) $ ( 0.79 ) $ ( 0.92 ) The following potentially dilutive issued and outstanding 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 as a result of the net loss position: September 30, 2024 2023 Stock option awards 4,583,289 4,705,390 Restricted stock units 4,574,045 1,853,657 Common stock warrants 135,686 — Total 9,293,020 6,559,047

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Segment Information	Note 10. 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 (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Revenue Surgical Glaucoma $ 18,632 $ 18,425 $ 57,132 $ 57,158 Dry Eye 1,525 1,584 3,660 5,147 Total 20,157 20,009 60,792 62,305 Cost of goods sold Surgical Glaucoma 2,453 2,002 7,084 6,808 Dry Eye 797 675 1,984 2,297 Total 3,250 2,677 9,068 9,105 Gross profit Surgical Glaucoma 16,179 16,423 50,048 50,350 Dry Eye 728 909 1,676 2,850 Total 16,907 17,332 51,724 53,200 Operating expenses 28,136 30,743 90,327 99,364 Loss from operations ( 11,229 ) ( 13,411 ) ( 38,603 ) ( 46,164 ) Investment income 1,454 1,897 4,628 5,499 Interest expense ( 1,151 ) ( 1,432 ) ( 3,501 ) ( 4,057 ) Loss on debt extinguishment — — ( 1,962 ) — Other income (expense), net 26 ( 11 ) ( 25 ) ( 34 ) Loss before income taxes $ ( 10,900 ) $ ( 12,957 ) $ ( 39,463 ) $ ( 44,756 ) 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 a segment basis. Substantially all of the Company’s revenue is generated from sales in the United States.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed consolidated financial statements and accompanying notes thereto are unaudited and have been prepared in accordance with accounting principles generally accepted in the United States of America ("US GAAP") applicable to interim periods and pursuant to the instructions to Form 10-Q and Article 10 of Regulation S-X. The Company’s condensed 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. The unaudited condensed consolidated financial statements have been prepared on a basis consistent with the audited consolidated financial statements. In the opinion of management, the unaudited condensed consolidated financial statements reflect all adjustments, which include only normal recurring adjustments, necessary for the fair presentation of the Company's financial information contained herein. The condensed consolidated balance sheet as of December 31, 2023 is derived from the Company's consolidated audited financial statements as of that date. These interim condensed consolidated financial statements do not include all disclosures required by US GAAP and should be read in conjunction with the Company's audited consolidated financial statements and the accompanying notes thereto for the fiscal year ended December 31, 2023, which are contained in the Annual Report. The Company's results of operations for the nine months ended September 30, 2024 are not necessarily indicative of the results to be expected for the year ending December 31, 2024 or for any other interim period.
Use of Estimates	Use of Estimates The preparation of the unaudited condensed consolidated 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, 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.
New Accounting Pronouncements	New Accounting Pronouncements Accounting Standards Recently Adopted During the nine-month period ended September 30, 2024, there were no significant Accounting Standard Updates ("ASUs") issued that were adopted. Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board ("FASB") issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. 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 on a retrospective basis for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024, 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 September 30, 2024, 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)	9 Months Ended
	Sep. 30, 2024
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. September 30, 2024 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. treasury securities $ 100,488 $ 24 $ ( 1 ) $ 100,511 December 31, 2023 Amortized Cost Unrealized Gains Unrealized Losses Aggregate Fair Value U.S. treasury securities $ 129,113 $ 28 $ — $ 129,141

Balance Sheet Components (Table

Balance Sheet Components (Tables)	9 Months Ended
	Sep. 30, 2024
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 September 30, As of December 31, 2024 2023 Tools and equipment $ 1,991 $ 2,010 Computer equipment and software 37 37 Furniture and fixtures 286 323 Leasehold improvements 38 38 Construction in process 1,071 859 3,423 3,267 Less: Accumulated depreciation ( 1,975 ) ( 1,627 ) Property and equipment, net $ 1,448 $ 1,640
Summary of Accrued and Other Current Liabilities	Accrued and other current liabilities consist of the following (in thousands): As of September 30, As of December 31, 2024 2023 Accrued expenses $ 2,447 $ 1,639 Current portion of lease liabilities 519 573 Short-term interest payable 311 375 Other accrued liabilities 1,336 1,187 Total accrued and other current liabilities $ 4,613 $ 3,774
Summary of Other Noncurrent Liabilities	Other noncurrent liabilities consist of the following (in thousands): As of September 30, As of December 31, 2024 2023 Noncurrent portion of lease liabilities $ 614 $ 914 Other noncurrent liabilities 75 38 Long-term interest payable — 1,524 Total other noncurrent liabilities $ 689 $ 2,476

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Long-term and Short-term Debt	Long-term and short-term debt as of September 30, 2024 and December 31, 2023, respectively, was as follows (in thousands): As of September 30, As of December 31, 2024 2023 Hercules Initial Loan $ 35,000 $ — MidCap Term Loan — 35,000 Total principal payments due 35,000 35,000 Less: unamortized discount and debt issuance costs ( 848 ) ( 1,073 ) Total amounts outstanding 34,152 33,927 Less: current portion — ( 2,219 ) Long-term debt, net $ 34,152 $ 31,708
Repayment Schedule Relating to the Company's Debt	The repayment schedule relating to the Hercules Initial Loan as of September 30, 2024, is as follows (in thousands): Amount 2024 (remainder) $ — 2025 — 2026 6,680 2027 17,294 Thereafter 11,026 Total principal payments $ 35,000 Final fee due at maturity 2,083 Total repayments $ 37,083

Commitments and Contingencies (

Commitments and Contingencies (Tables)	9 Months Ended
	Sep. 30, 2024
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 three months ended September 30, 2024 and 2023 were as follows (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Operating lease expense $ 196 $ 288 $ 587 $ 869 Cash paid for operating leases 162 295 582 885
Schedule of Aggregate Future Minimum Lease Payments	Aggregate future minimum lease payments as of September 30, 2024, under these noncancelable operating leases were as follows (in thousands): As of September 30, 2024 2024 (remainder) $ 158 2025 618 2026 497 Total future minimum lease payments $ 1,273 Less: imputed interest ( 140 ) Present value of future minimum lease payments $ 1,133 Less: current portion of operating lease liability ( 519 ) Noncurrent portion of lease liabilities $ 614

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Reserved Common Stock for Future Issuances	At September 30, 2024 and December 31, 2023, the Company had reserved common stock for future issuances as follows: September 30, December 31, 2024 2023 Common stock available for future grants 5,956,636 6,033,176 Common stock options issued and outstanding 4,583,289 4,980,190 Restricted stock units outstanding 4,574,045 2,721,361 Shares available for future purchase under employee stock purchase plan 1,747,250 1,488,227 Total 16,861,220 15,222,954

Equity Incentive Plans (Tables)

Equity Incentive Plans (Tables)	9 Months Ended
	Sep. 30, 2024
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 2021 Plan during the periods presented: Number of Weighted-Average Exercise Price Weighted-Average Average Intrinsic Value Balances as of December 31, 2023 4,980,190 $ 9.00 7.4 $ 5,924 Grants 7,377 4.43 Forfeited/cancelled ( 210,159 ) 10.15 Exercised/released ( 194,119 ) 1.20 Balances as of September 30, 2024 4,583,289 $ 9.28 7.0 $ 6,558 Vested and exercisable as of September 30, 2024 3,163,058 $ 9.32 6.4 $ 4,635 Vested and expected to vest as of September 30, 2024 4,583,289 $ 9.28 7.0 $ 6,558
Summary of Weighted Average Valuation Assumptions Used to Estimate Fair Value of Employee Stock Options	The fair value for options granted was calculated using the following weighted average assumptions: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Expected term (in years) N/A 5.99 – 6.01 6.13 5.60 – 6.07 Expected volatility N/A 79.82 % 61.67 % 78.53 % – 79.82 % Risk-free interest rate N/A 4.04 % 4.28 % 3.48 % – 4.04 % Dividend yield N/A – – –
Share-based Payment Arrangement, Restricted Stock Unit, Activity	The following table summarizes restricted share award activity: Number of Weighted-Average Grant Date Fair Value Per Share Outstanding, December 31, 2023 2,721,361 $ 7.61 Grants 2,949,065 4.46 Forfeited/cancelled ( 213,175 ) 6.54 Vested ( 883,206 ) 7.58 Outstanding, September 30, 2024 4,574,045 $ 5.62
Summary of Stock-Based Compensation Expense by Function	The following is a summary of stock-based compensation expense by function (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Cost of goods sold $ 83 $ 77 $ 283 $ 206 Research and development 588 549 1,787 1,664 Selling, general and administrative 3,637 3,230 11,061 9,251 Total stock-based compensation expense $ 4,308 $ 3,856 $ 13,131 $ 11,121
2021 Employee Stock Purchase Plan
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 three and nine months ended September 30, 2024 and 2023: Three Months Ended Nine Months Ended 2024 2023 2024 2023 Expected term (in years) 0.49 – 0.50 0.48 – 0.50 0.49 – 0.50 0.48 – 0.50 Expected volatility 100.00 % – 197.51 % 66.72 % – 97.38 % 100.00 % – 197.51 % 66.72 % – 97.38 % Risk-free interest rate 5.37 % – 5.40 % 4.62 % – 5.32 % 5.37 % – 5.40 % 4.62 % – 5.32 % Dividend yield – – – –

Net Loss per Share Attributab_2

Net Loss per Share Attributable to Common Stockholders (Tables)	9 Months Ended
	Sep. 30, 2024
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 for the periods presented (in thousands, except share and per share data): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Numerator: Net loss attributable to common stockholders $ ( 11,066 ) $ ( 13,035 ) $ ( 39,661 ) $ ( 44,856 ) Denominator: Weighted-average shares of common stock 50,340,603 48,671,049 49,911,655 48,538,517 Net loss per share attributable to common $ ( 0.22 ) $ ( 0.27 ) $ ( 0.79 ) $ ( 0.92 )
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potentially dilutive issued and outstanding 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 as a result of the net loss position: September 30, 2024 2023 Stock option awards 4,583,289 4,705,390 Restricted stock units 4,574,045 1,853,657 Common stock warrants 135,686 — Total 9,293,020 6,559,047

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Schedule of Segment Reporting Information	The following table summarizes select operating results information for each reportable segment (in thousands): Three Months Ended Nine Months Ended 2024 2023 2024 2023 Revenue Surgical Glaucoma $ 18,632 $ 18,425 $ 57,132 $ 57,158 Dry Eye 1,525 1,584 3,660 5,147 Total 20,157 20,009 60,792 62,305 Cost of goods sold Surgical Glaucoma 2,453 2,002 7,084 6,808 Dry Eye 797 675 1,984 2,297 Total 3,250 2,677 9,068 9,105 Gross profit Surgical Glaucoma 16,179 16,423 50,048 50,350 Dry Eye 728 909 1,676 2,850 Total 16,907 17,332 51,724 53,200 Operating expenses 28,136 30,743 90,327 99,364 Loss from operations ( 11,229 ) ( 13,411 ) ( 38,603 ) ( 46,164 ) Investment income 1,454 1,897 4,628 5,499 Interest expense ( 1,151 ) ( 1,432 ) ( 3,501 ) ( 4,057 ) Loss on debt extinguishment — — ( 1,962 ) — Other income (expense), net 26 ( 11 ) ( 25 ) ( 34 ) Loss before income taxes $ ( 10,900 ) $ ( 12,957 ) $ ( 39,463 ) $ ( 44,756 )

Company and Nature of Business

Company and Nature of Business - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2023
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Accumulated deficit	$ (334,451)		$ (334,451)		$ (294,790)
Net Income (Loss)	$ (11,066)	$ (13,035)	$ (39,661)	$ (44,856)

Fair value Measurement - Additi

Fair value Measurement - Additional Information (Details) - Fair Value, Recurring - USD ($) $ in Millions	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Treasury bills	$ 100.5	$ 129.1
Fair Value, Inputs, Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Debt Instrument, Fair Value Amount	34.2	$ 33.9
Fair Value, Inputs, Level 3
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair value of the unissued common stock warrants	$ 0.1

Fair Value Measurement - Held-t

Fair Value Measurement - Held-to-maturity debt securities at amortized cost (Details) - US Treasury Securities [Member] - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Amortized Cost	$ 100,488	$ 129,113
Unrealized Gains	24	28
Unrealized Losses	(1)	0
Aggregate Fair Value	$ 100,511	$ 129,141

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Property and Equipment, Net (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 3,423	$ 3,267
Less: Accumulated depreciation	(1,975)	(1,627)
Property and equipment, net	1,448	1,640
Tools and Equipment
Property Plant And Equipment [Line Items]
Property and equipment, gross	1,991	2,010
Computer Equipment and Software
Property Plant And Equipment [Line Items]
Property and equipment, gross	37	37
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Property and equipment, gross	286	323
Leasehold Improvements
Property Plant And Equipment [Line Items]
Property and equipment, gross	38	38
Construction In Process
Property Plant And Equipment [Line Items]
Property and equipment, gross	$ 1,071	$ 859

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Depreciation expense	$ 0.1	$ 0.2	$ 0.4	$ 0.5

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Accrued and Other Current Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Accrued expenses	$ 2,447	$ 1,639
Current portion of lease liabilities	519	573
Short-term interest payable	311	375
Other accrued liabilities	1,336	1,187
Total accrued and other current liabilities	$ 4,613	$ 3,774

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Other Noncurrent Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Long-term interest payable	$ 0	$ 1,524
Noncurrent portion of lease liabilities	614	914
Other noncurrent liabilities	75	38
Total other noncurrent liabilities	$ 689	$ 2,476

Debt - Additional Information (

Debt - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended
	Jan. 31, 2024	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jan. 22, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Loss on debt extinguishment		$ 0	$ 0	$ (1,962)	$ 0
Fair value of warrants				600
Long-term debt, net		$ 34,152		$ 34,152			$ 31,708
Hercules Credit Agreement [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 65,000
Line of credit achievement of certain performance milestones	10,000
Line of credit facility, remaining borrowing capacity	$ 15,000
Maturity date	Jul. 01, 2028
Interest in increments period	$ 5,000
Debt instrument, frequency of periodic payment	30 months
Debt instrument interest payment extended term	36 months
Debt instrument, variable rate	10.35%
Debt instrument, Initial interest rate		10.35%		10.35%
Interest Rate During Period	5.95%
Debt instrument, effective interest rate	2.35%
Warrants issued to purchase shares of convertible preferred stock		135,686		135,686
Class of warrant exercise price		$ 5.159		$ 5.159
Line of credit facility, current borrowing capacity						$ 35,000
Hercules Credit Agreement [Member] | Tranche Two Loans
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 5,000
Mid Cap Financial Services
Debt Instrument [Line Items]
Loss on debt extinguishment				$ 2,000
Debt instrument, variable rate				7%
Mid Cap Financial Services | Senior Secured 2019 Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 35,000		$ 35,000
Lenders [Member] | Hercules Credit Agreement [Member]
Debt Instrument [Line Items]
Warrants Expiration Term	7 years
Warrants issued to purchase shares of convertible preferred stock	135,686
Class of warrant exercise price	$ 5.159
MidCap Credit Facility Agreements [Member]
Debt Instrument [Line Items]
Long-term debt, net		$ 35,000		$ 35,000
Percentage of long term debt fee payable		6%		6%

Debt - Schedule of Long-term an

Debt - Schedule of Long-term and Short-term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total principal payments due	$ 35,000	$ 35,000
Less: unamortized discount and debt issuance costs	(848)	(1,073)
Total amounts outstanding	34,152	33,927
Less: current portion	0	(2,219)
Long-term debt, net	34,152	31,708
Hercules Credit Agreement [Member]
Debt Instrument [Line Items]
Total principal payments due	35,000	0
MidCap Term Loan [Member]
Debt Instrument [Line Items]
Total principal payments due	$ 0	$ 35,000

Debt - Schedule Relating to the

Debt - Schedule Relating to the Company's Debt (Details) $ in Thousands	Sep. 30, 2024 USD ($)
Debt Disclosure [Abstract]
2024 (remainder)	$ 0
2025	0
2026	6,680
2027	17,294
Thereafter	11,026
Total principal payments	35,000
Final fee due at maturity	2,083
Total repayments	$ 37,083

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Dec. 31, 2022	Dec. 31, 2023
Supply Commitment [Line Items]
Operating lease right-of-use assets	$ 1,100		$ 1,100			$ 1,458
Remaining lease term	2 years		2 years
Operating leases, rent expense	$ 196	$ 288	$ 587	$ 869
Supply agreement [Member]
Supply Commitment [Line Items]
Extending the lease term			26
Operating lease right-of-use assets	$ 1,200		$ 1,200		$ 700
Lease, borrowing rate	11.40%		11.40%		10.75%
Operating lease term	37 months		37 months		18 months
Remaining lease term	34 months		34 months
Total base rent under lease agreement			$ 1,500		$ 700

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Operating Lease Expense Recognized and Supplemental Cash Flow (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Operating lease expense	$ 196	$ 288	$ 587	$ 869
Cash paid for operating leases	$ 162	$ 295	$ 582	$ 885

Commitments and Contingencies_3

Commitments and Contingencies - Schedule of Aggregate Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
2024 (remainder)	$ 158
2025	618
2026	497
Total future minimum lease payments	1,273
Less: imputed interest	(140)
Present value of future minimum lease payments	1,133
Less: current portion of operating lease liability	(519)	$ (573)
Noncurrent portion of lease liabilities	$ 614	$ 914

Stockholder's Equity - Addition

Stockholder's Equity - Additional Information (Details) $ / shares in Units, $ in Thousands	9 Months Ended
	Sep. 30, 2024 USD ($) Vote $ / shares shares	Dec. 31, 2023 $ / shares shares
Subsidiary, Sale of Stock [Line Items]
Common stock, shares authorized	200,000,000	200,000,000
Preferred stock, shares authorized	10,000,000	10,000,000
Common stock, par value | $ / shares	$ 0.001	$ 0.001
Preferred stock par value | $ / shares	$ 0.001	$ 0.001
Dividends declared | $	$ 0
Additional warrants to purchase common stock	2%
Number of votes entitled per share of common stock | Vote	1
Fair value of warrants | $	$ 600
Common stock, shares issued	50,398,148	49,131,363
Hercules Credit Agreement [Member]
Subsidiary, Sale of Stock [Line Items]
Warrants to purchase common stock	135,686
Class of warrant exercise price | $ / shares	$ 5.159
Maximum [Member]
Subsidiary, Sale of Stock [Line Items]
Unused warrants value | $	$ 100
IPO [Member]
Subsidiary, Sale of Stock [Line Items]
Common stock, shares authorized	200,000,000
Preferred stock, shares authorized	10,000,000
Common stock, par value | $ / shares	$ 0.001
Preferred stock par value | $ / shares	$ 0.001

Stockholder's Equity - Schedule

Stockholder's Equity - Schedule of Reserved Common Stock for Future Issuances (Details) - shares	Sep. 30, 2024	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock reserved for future issuance	16,861,220	15,222,954
Common stock available for future grants
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock reserved for future issuance	5,956,636	6,033,176
Common stock options issued and outstanding
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock reserved for future issuance	4,583,289	4,980,190
Restricted stock units outstanding
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock reserved for future issuance	4,574,045	2,721,361
Shares available for future purchase under employee stock purchase plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Common stock reserved for future issuance	1,747,250	1,488,227

Equity Incentive Plans - Additi

Equity Incentive Plans - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023	Jan. 01, 2024	Dec. 31, 2023	Jan. 01, 2023	Jul. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Weighted-average grant-date fair values of options granted			$ 2.71	$ 6.92
Aggregate intrinsic value of options exercised	$ 200		$ 800
Unrecognized stock-based compensation of unvested options	$ 8,100		$ 8,100
Weighted-average period expected to recognize			1 year 3 months 18 days
Common stock reserved for future issuance	16,861,220		16,861,220			15,222,954
Description of Transaction of Future issuance			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
Number of Shares, Grants			7,377
Weighted-Average Exercise Price, Granted			$ 4.43
Stock based compensation	$ 1,900	$ 2,100	$ 5,700	$ 6,600
Share of common stock purchased	4,308	3,856	13,131	11,121
ESPP purchase			450	661
Restricted Stock Units RSU
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Unrecognized stock-based compensation of unvested options	21,200		$ 21,200
Weighted-average period expected to recognize			2 years 8 months 12 days
Stock based compensation	$ 2,200	1,600	$ 6,900	4,200
2021 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock available for issuance	5,956,636		5,956,636			6,033,176
Common stock reserved for future issuance	5,200,000		5,200,000		2,456,568		2,414,907
2021 Employee Stock Purchase Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Collected withholdings under plan			$ 400
Common stock reserved for future issuance	1,747,250		1,747,250		491,313		482,981	850,000
Stock based compensation	$ 100	$ 100	$ 500	$ 400
ESPP purchase, Shares			232,290
ESPP purchase			$ 500

Equity Incentive Plans - Summar

Equity Incentive Plans - Summary of Company Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Number of Shares	4,980,190
Number of Shares, Grants	7,377
Number of Shares, Forfeited/cancelled	(210,159)
Number of Shares, Exercised/released	(194,119)
Number of Shares	4,583,289	4,980,190
Number of Shares Vested and exercisable as of September 30, 2024	3,163,058
Number of Shares, Vested and expected to vest as of September 30, 2024	4,583,289
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Weighted Average Exercise Price
Weighted-Average Exercise Price	$ 9
Weighted-Average Exercise Price, Granted	4.43
Weighted-Average Exercise Price, Forfeited/cancelled	10.15
Weighted-Average Exercise Price, Exercised/released	1.2
Weighted-Average Exercise Price	9.28	$ 9
Vested and exercisable as of September 30, 2024	9.32
Vested and expected to vest as of September 30, 2024	$ 9.28
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Remaining Contractual Term
Weighted Average Remaining Contractual Term	7 years	7 years 4 months 24 days
Weighted average contractual term, vested and exercisable	6 years 4 months 24 days
Weighted average contractual term, vested and expected	7 years
Average Intrinsic Value	$ 6,558	$ 5,924
Average Intrinsic Value, Vested and exercisable as of September 30, 2024	4,635
Average Intrinsic Value, Vested and expected as of September 30, 2024	$ 6,558

Equity Incentive Plans - Summ_2

Equity Incentive Plans - Summary of Stock Based Compensation Fair Value Assumptions (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected term (in years)			6 years 1 month 17 days
Expected volatility		79.82%	61.67%
Risk-free interest rate		4.04%	4.28%
Maximum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected term (in years)		6 years 3 days		6 years 25 days
Expected volatility				79.82%
Risk-free interest rate				4.04%
Maximum | 2021 Employee Stock Purchase Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected term (in years)	6 months	6 months	6 months	6 months
Expected volatility	197.51%	97.38%	197.51%	97.38%
Risk-free interest rate	5.40%	5.32%	5.40%	5.32%
Minimum
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected term (in years)		5 years 11 months 26 days		5 years 7 months 6 days
Expected volatility				78.53%
Risk-free interest rate				3.48%
Minimum | 2021 Employee Stock Purchase Plan
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected term (in years)	5 months 26 days	5 months 23 days	5 months 26 days	5 months 23 days
Expected volatility	100%	66.72%	100%	66.72%
Risk-free interest rate	5.37%	4.62%	5.37%	4.62%

Equity Incentive Plans - Summ_3

Equity Incentive Plans - Summary of Share-Based Compensation Expense By Function (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 4,308	$ 3,856	$ 13,131	$ 11,121
Cost of Goods Sold
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	83	77	283	206
Research and Development
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	588	549	1,787	1,664
Selling, General and Administrative
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Total stock-based compensation expense	$ 3,637	$ 3,230	$ 11,061	$ 9,251

Equity Incentive Plans - Summ_4

Equity Incentive Plans - Summarizes restricted share award activity under the 2021 Plan (Details) - Restricted Stock [Member]	9 Months Ended
	Sep. 30, 2024 $ / shares shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares, Outstanding, December 31, 2023 | shares	2,721,361
Number of Shares, Grants | shares	2,949,065
Number of Shares, Forfeited/cancelled | shares	(213,175)
Number of Shares, Vested | shares	(883,206)
Number of Shares, Outstanding, September 30, 2024 | shares	4,574,045
Weighted- Average Grant Date Fair Value Per Share, Outstanding, December 31, 2023 | $ / shares	$ 7.61
Weighted- Average Grant Date Fair Value Per Share, Grants | $ / shares	4.46
Weighted- Average Grant Date Fair Value Per Share, Forfeited/cancelled | $ / shares	6.54
Weighted- Average Grant Date Fair Value Per Share, Vested | $ / shares	7.58
Weighted- Average Grant Date Fair Value Per Share, Outstanding, September 30, 2024 | $ / shares	$ 5.62

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	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Numerator:
Net loss attributable to common stockholders	$ (11,066)	$ (13,035)	$ (39,661)	$ (44,856)
Denominator:
Weighted-average shares of common stock outstanding-basic	50,340,603	48,671,049	49,911,655	48,538,517
Weighted-average shares of common stock outstanding-diluted	50,340,603	48,671,049	49,911,655	48,538,517
Net loss per share attributable to common stockholders-basic	$ (0.22)	$ (0.27)	$ (0.79)	$ (0.92)
Net loss per share attributable to common stockholders-diluted	$ (0.22)	$ (0.27)	$ (0.79)	$ (0.92)

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	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Redeemable convertible preferred stock	9,293,020	6,559,047
Stock option awards
Redeemable convertible preferred stock	4,583,289	4,705,390
Restricted Stock Units
Redeemable convertible preferred stock	4,574,045	1,853,657
Common stock warrants
Redeemable convertible preferred stock	135,686	0

Segment Information - Additiona

Segment Information - Additional Information (Details)	9 Months Ended
	Sep. 30, 2024 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	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue
Revenue	$ 20,157	$ 20,009	$ 60,792	$ 62,305
Cost of goods sold
Cost of goods sold	3,250	2,677	9,068	9,105
Gross profit
Gross profit	16,907	17,332	51,724	53,200
Operating expenses	28,136	30,743	90,327	99,364
Loss from operations	(11,229)	(13,411)	(38,603)	(46,164)
Investment income	1,454	1,897	4,628	5,499
Interest expense	(1,151)	(1,432)	(3,501)	(4,057)
Loss on debt extinguishment	0	0	(1,962)	0
Other income (expense), net	26	(11)	(25)	(34)
Loss before income taxes	(10,900)	(12,957)	(39,463)	(44,756)
Surgical Glaucoma
Revenue
Revenue	18,632	18,425	57,132	57,158
Cost of goods sold
Cost of goods sold	2,453	2,002	7,084	6,808
Gross profit
Gross profit	16,179	16,423	50,048	50,350
Dry Eye
Revenue
Revenue	1,525	1,584	3,660	5,147
Cost of goods sold
Cost of goods sold	797	675	1,984	2,297
Gross profit
Gross profit	$ 728	$ 909	$ 1,676	$ 2,850