Hello and thanks for your question. There are several known causes of this. One is inflammation. Any inflammation in the eye can predispose this to happen. If he hasn't had any eye problems that he's known about this is unlikely to be the case. Any eye surgery can predispose to this, so if he's had cataract surgery, for example, this can predispose to the wrinkling. Trauma can also predispose to this. Lastly, perhaps idiopathic macular puckering is the most common cause--which is medical speak to say we can't identify a cause--it just happens.
You are correct in that there is no known treatment for this other than surgery. If his vision starts to become worse than 20/30 or objects that he views become distorted such that it starts to affect his life, then surgery is something you should consider. But if his vision is better than 20/30 or if there are no significant effects on his daily activities, it would be wise to just observe this for now because the major surgery done to relieve this can often leave someone 20/30 at their best after the surgery.
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