This paper is particularly relevant to those charged with providing refraction, ocular health and vision screening services to children with complex needs and in particular those with CVI. CVI is the commonest cause of visual impairment in children in the developed world. Whilst often diagnosed in association with a developmental delay, there is a cohort of children with typical development and normal visual acuity who demonstrate atypical visual function. Being aware of risk factors from a clinical history, and alert to the array of visual symptoms that may present to an optometrist, will enable optometrists to identify and refer children more readily to access diagnostic and supportive services.