Correct! The diagnosis is not in doubt here. If all studies were correctly interpreted, she has idiopathic intracranial hypertension (IIH, pseudotumor cerebri). It has caused only minimal damage to visual function. Yet the optic discs remain moderately elevated, so the question is whether she is at risk for eventual optic nerve damage if left untreated. We do not know the answer to that important question, and no tests can reliably help us. What we do know is that the surgical options entail considerable risks. Lumbo-peritoneal shunts have given way to ventriculo-peritoneal shunts because of technical problems. Ventriculo-peritoneal shunts are not difficult to perform, but they have a 20% chance of complications, some serious. Venous sinus stenting is an option, but it too has risks and experience is limited. Bariatric surgery, not one of the answer choices here, might solve the intracranial pressure problem, but has its own adverse consequences. In the end, “watchful waiting” is probably the most prudent approach here. One fact favors this approach: if visual function in IIH is to deteriorate, it usually does so early in the course of management.