At birth, the embryonic and fetal nuclei make up most of the lens. Postnatally, cortical lens fibers are laid down from the conversion of anterior lens epithelium into cortical lens fibers. The location and pattern of this opacification may be used to determine the timing of the insult as well as the etiology. Mental retardation, deafness, kidney disease, heart disease, and other systemic involvement may be part of the presentation. Congenital cataracts are present at birth but may not be identified until later in life.
Some cataracts are static, but some are progressive.
This explains why not all congenital cataracts are identified at birth. Not all cataracts are visually significant. If a lenticular opacity is in the visual axis, it usually is considered visually significant and requires removal. A lenticular opacity is called a cataract. Not all cataracts are visually significant.