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Investments in Joint Ventures - S & I Ophthalmic - Additional Information (Details) $ in Thousands | 1 Months Ended | 12 Months Ended |
--- | --- | --- | ---
Oct. 31, 2013 USD ($) | Dec. 31, 2015 USD ($) | Sep. 30, 2016 USD ($) board_seat
Schedule of Equity Method Investments [Line Items] |  |  |
Investment |  | $ 9,977 | $ 25,847
S & I Ophthalmic, LLC |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |
Capital contributions | $ 5,000 | 5,000 |
Membership interest | 50.00% |  |
Total number of seats on the joint venture's governing board | board_seat |  |  | 4
S & I Ophthalmic, LLC | Investors |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |
Capital contributions | $ 5,000 | 5,000 |
Membership interest | 50.00% |  |
S & I Ophthalmic, LLC | Investments In Affiliates |  |  |
Schedule of Equity Method Investments [Line Items] |  |  |
Investment |  | $ 6,379 | $ 3,737

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