Sight Sciences Inc.’s stock SGHT tumbled 32% premarket Tuesday, after the eyecare technology company issued a revenue warning, saying it’s seen fewer Surgical Glaucoma new accounts in the third quarter amid reimbursement uncertainty. The Menlo Park, Calif.-based company said it now expects third-quarter revenue of $19.0 million to $20.0 million, below the $22.9 million FactSet consensus. In June, five of the seven Medicare Administrative Contractors (MACs) published local coverage determinations, or LCDs, that could identify many non-implantable micro-invasive glaucoma surgery procedures, including the company’s surgical glaucoma technologies, as investigational and non-covered for Medicare beneficiaries in the states covered by these five MACs, said Sight Sciences. In dry eye, the company is expecting revenue to be slightly lower sequentially due to seasonality, plus a strategy that expects higher utilization by existing customer accounts as part of its reimbursement strategy. “We typically see a strong second quarter followed by a slower start to the third quarter given traditional seasonality patterns,” said Founder and CEO Paul Badawi in a statement. “While we had a strong second quarter prior to the LCD proposals, we have faced a lower cadence of new account additions and relatively flat utilization and we have not experienced the expected increase in commercial activity thus far in August and early September.” For all of 2023, the company is expecting revenue of $80.0 million to $82.0 million, down 12% to 15% from 2022 and compared with a FactSet consensus of $90.5 million. The stock has fallen 47% in the year to date, while the S& 500 SPX has gained 17%.

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