The ophthalmic artery arises from the internal carotid at the level of the carotid siphon; in 3.5-5% of the population, it arises from the middle meningeal artery, a branch of the internal maxillary artery, terminal of the external carotid artery. We report a rare case of bilateral malformation in a 28-year-old patient. Our study covers the possible dual origin of orbital blood vascularization. This variation in the anatomic distribution is important to know, particularly if embolization is intended as inadvertent occlusion of the ophthalmic artery, because it may lead to permanent loss of vision.