Aim To investigate the underlying factor structure of the 46‐item Flemish cerebral visual impairment (CVI) questionnaire, differentiate the factor scores of children with and without CVI, and examine the impact of comorbidities on factor scores. Method The records of 630 children (386 males, 244 females; median age 77mo; interquartile range 63–98mo) who visited the CVI clinic and the Centre for Developmental Disabilities at the University Hospitals of Leuven from 2001 to 2018 were reviewed systematically. Inclusion criteria included an up‐to‐date questionnaire, a definitive diagnosis, and clinical assessment. Results Three hundred and forty‐five children (179 with CVI [108 males, 71 females; median age 74mo; interquartile range 61–93mo] and 166 without CVI [110 males, 56 females; median age 88mo; interquartile range 70–107mo]) were included. An exploratory factor analysis resulted in a 5‐factor (object and face processing impairments; visual (dis)interest; clutter and distance viewing impairments; moving in space impairments; and anxiety‐related behaviours) biologically and clinically plausible model, which retained 35 items and explained 56% of the total variance. Mann–Whitney U tests indicated that factors 1 to 4 were significantly higher in children with CVI compared to children without CVI (p‐values ranged from p<0.001 to p<0.05; effect sizes ranged from 0.11 to 0.33); factor 5 showed no differences. Autism, developmental coordination disorder, epilepsy, and cerebral palsy impacted factor scores. Interpretation A 5‐factor structure of the Flemish CVI questionnaire differentiates children with and without CVI. Comorbidities should be accounted for when researching CVI. What this paper adds Cerebral visual impairment (CVI) is characterized by impaired object and face processing and impaired visual interest. CVI is also characterized by impaired clutter and distance viewing, and impaired moving in space. All children (with or without CVI) demonstrated anxiety‐related behaviours. Autism affected object/face processing, whereas developmental coordination disorder, epilepsy, and cerebral palsy affected visual interest.

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