Giant aneurysms of the anterior intracranial circulation are rare, slowly progressive vascular abnormalities, often presenting with neuro-ophthalmological symptoms before they rupture. This is a case of a 55-year-old woman with a double aneurysm of the anterior intracranial circulation, part of which was giant, diagnosed exclusively on the basis of ocular manifestations. We also describe successful management of the case throughout a long follow-up period.