Kenneth Fisher describes his SSMS setup:
Every time I install a new version of SSMS I make a handful of changes to the default setup. For my own notes, and in case anyone is interested in some of the things you can do with SSMS I thought I’d post a list of those changes.
I also use a darker theme, very similar to Fisher’s; mine is designed to look like vim blue. Of course, personal SSMS settings are personal.