Elevated IOP due to elevated episcleral venous pressure secondary to superior vena cava syndrome
B. Perform systemic workup, including chest imaging
While stopping a topical corticosteroid (A) may be considered, the incidence of corticosteroid response after Baerveldt tube placement is low.1,2 Adding a rho kinase inhibitor (C) to the 4 classes of topical antihypertensives or placing a second nonvalved tube shunt with adjuvant micropulse laser (D) would both be reasonable choices if the tube shunt was not functioning well. However, neither of these choices are appropriate, given apparent patency of the Baerveldt tube and the patient’s systemic symptoms.