Introduction: Cerebral Visual Impairment (CVI) is a predominant cause of childhood visual impairment. Early identification is essential to leverage neuroplasticity , which is crucial for managing visual processing deficits and improving developmental outcomes. Objectives: This study aimed to describe parent-reported pre-diagnostic clinical manifestations and calculate the lag periods between suspicion, diagnosis, and the initiation of visual rehabilitation. Methods: A retrospective cohort study was conducted involving 50 children (aged 0–72 months; 54% females) at a Sri Lankan tertiary hospital. Data were gathered using a 56-item parent reported questionnaire covering clinical manifestations as well as an intervieweradministered questionnaire. Results: The mean age of diagnosis was 18.5 months (SD=29.9), with children categorised into CVI Stage I (26%), II (22%), and III (16%). Leading risk factors were kernicterus (28%), prematurity (24%), and hypoxic-ischaemic encephalopathy (24%); common comorbidities included epilepsy (28%) and cerebral palsy (14%). High-frequency clinical manifestations included inability to follow moving objects (54%), staring at objects (50%), and light gazing (46%). While 80% of parents noted concerns within 12 months, only 34% utilised the Child Health Development Record (CHDR). However, all parents in the parent-reported group (30%) utilised the CHDR to formalise their suspicions. Surveillance identified 98% of at-risk cases. Doctors made all referrals and were responsible for incidental findings (34%). Furthermore, 92% were diagnosed within six months of suspicion, and 70% initiated rehabilitation within six months of diagnosis. Conclusions: Parental observation and robust surveillance systems facilitate an efficient clinical pathway for rapid diagnosis and intervention, which is vital for effective CVI management.