Bausch + Lomb (NYSE:BLCO) executives highlighted what they described as a record fourth quarter and full-year 2025 performance, driven by broad-based revenue growth, accelerating profitability, and continued momentum in dry eye during the company’s fourth-quarter 2025 earnings call.
Record Q4 and full-year 2025 results
Chairman and CEO Brent Saunders said the company “grew smarter and faster than the market,” pointing to 7% constant-currency revenue growth in the fourth quarter and 27% adjusted EBITDA growth as evidence of “real operating leverage.” He noted the quarter’s $1.4 billion in revenue and $330 million in adjusted EBITDA as company “high watermarks,” while acknowledging the business has seasonality, with the first quarter typically the lowest and the fourth quarter the highest.
Adjusted EBITDA in the fourth quarter was $330 million, up 27%, with an adjusted EBITDA margin of 23.5%, which Eldessouky said was the highest level the company has achieved as a standalone company since its IPO. Full-year adjusted EBITDA was $891 million, and adjusted EBITDA margin for the full year was 17.5%.
Segment performance: Vision Care, Surgical, and Pharma
In Vision Care, fourth-quarter revenue was $778 million, up 5%, with full-year revenue of $2.923 billion, up 6%. The consumer business rose 3% in the quarter and 5% for the year. Eldessouky cited:
- Lumify revenue of $63 million in Q4 (up 24%) and $221 million for the year (up 16%)
- Consumer dry eye portfolio revenue of $116 million in Q4 (up 6%), led by Blink growth of 33%
- Full-year consumer dry eye revenue of $436 million (up 14%)
Contact lens revenue increased 8% in Q4 and 7% for the full year, led by daily silicone hydrogel (SiHy), which rose 17% in Q4 and 28% for the year. The company said the U.S. contact lens business grew 11% in Q4 and 9% for the year, while international grew 6% in Q4 and 5% for the year. In China, contact lenses grew 7% in Q4 and 8% for the full year.
Surgical segment revenue was $249 million in Q4, up 3% (or 6% excluding the impact of the enVista recall). Full-year surgical revenue was $894 million, up 4% (or 10% excluding the recall). Eldessouky said premium intraocular lenses (IOLs) grew 20% in Q4 and 26% for the year.
In pharma, Q4 revenue was $378 million, up 14%, and full-year revenue was $1.284 billion, up 6%. The U.S. branded Rx business grew 21% in Q4 and 13% for the year, led by MIEBO, which posted $112 million in Q4 revenue (up 111% year-over-year and 33% sequentially). Full-year MIEBO revenue was $316 million, up 84%. XIIDRA generated $95 million in Q4 revenue and $331 million for the year.
Dry eye focus: MIEBO and XIIDRA outlook
President of Global Pharmaceuticals and International Consumer Andrew Stewart called MIEBO’s 2025 performance “exceptional,” citing 113% year-over-year prescription growth and noting the brand crossed 2 million prescriptions on Jan. 2. Stewart said the company previously projected peak sales of $500 million for MIEBO, but now believes peak sales could exceed $600 million based on its performance less than three years after launch.
On XIIDRA, Stewart said prescriptions grew 6% year-over-year in the fourth quarter, marking the highest quarterly total prescriptions since launch. Management said XIIDRA and MIEBO have “best-in-class” coverage, with four out of five patients covered. In Q&A, executives indicated they expect slower prescription growth for XIIDRA due to market access dynamics, but higher revenue growth driven by improved net pricing.
Stewart also characterized dry eye disease as “underpenetrated,” stating that about one in ten patients are actively treated with prescription therapy. He said the overall dry eye market is expanding due to factors including aging, environmental conditions, and increased screen time.
2026 guidance and margin expansion drivers
For 2026, Eldessouky guided to revenue of $5.375 billion to $5.475 billion, representing 5% to 7% constant-currency growth. The company estimated a currency tailwind of approximately $30 million to revenue based on current exchange rates.
Adjusted EBITDA guidance was $1.0 billion to $1.05 billion, implying an EBITDA margin of roughly 19% at the midpoint and about 15% EBITDA growth year over year. Eldessouky said the company expects adjusted gross margin of about 62% and R&D investment of 7.5% to 8% of revenue. The company expects interest expense of approximately $365 million, an adjusted tax rate of about 19%, and CapEx of about $285 million.
In Q&A, Eldessouky attributed the margin outlook to a combination of gross margin improvement, SG&A efficiencies, and targeted investment, while noting fourth-quarter adjusted gross margin of 62.1% included an approximate 80 basis point tariff impact. He also said that, excluding certain items, the company expects about 200 basis points of EBITDA margin improvement in 2026, including about 100 basis points from gross margin and about 100 basis points from SG&A, partially offset by higher R&D.
On quarterly phasing, management reiterated that Q1 is typically the lowest quarter and Q4 the highest, and said this seasonality is expected to become more pronounced as the dry eye franchise grows.
Pipeline updates, product launches, and recall commentary
Saunders pointed to upcoming consumer launches, including PreserVision AREDS 3 shipping beginning Feb. 2 and Blink Triple Care Preservative Free expected to ship on March 1. He also said a CE Mark submission for Silera, a next-generation femtosecond laser, is expected “next week,” with anticipated approval in the second half of the year.
On contact lens R&D, management discussed top-line data from a first external study of a new bioactive lens material, later identified in Q&A as the Halo daily disposable contact lens. An executive said the study enrolled about 130 participants, reported no adverse events or device deficiencies, and that investigators found clear vision in approximately 98.5% of subjects. The company said it remains on track for a planned 2028 launch.
In surgical, Saunders said the company met its goal of returning to pre-recall levels ahead of schedule and expects to stop proactively referencing the voluntary enVista recall on future earnings calls. In Q&A, he added that while premium IOLs rebounded faster, monofocal IOL recovery may take longer due to contracting cycles at ambulatory surgery centers and practices.
Separately, Saunders addressed investor questions about share float, saying it is “not within our control” and tied to decisions by BHC, though he said BHC has indicated it plans to sell shares over time without providing a timeline.
About Bausch + Lomb (NYSE:BLCO)
Bausch + Lomb Corporation operates as an eye health company in the United States, Puerto Rico, China, France, Japan, Germany, the United Kingdom, Canada, Russia, Spain, Italy, Mexico, Poland, South Korea, and internationally. It operates in three segments: Vision Care, Pharmaceuticals, and Surgical. The Vision Care segment provides contact lens that covers the spectrum of wearing modalities, including daily disposable and frequently replaced contact lenses; and contact lens care products comprising over-the-counter eye drops, eye vitamins, and mineral supplements that address various conditions, such as eye allergies, conjunctivitis, dry eye, and redness relief.
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