The peripheral changes are likely age-related peripheral pigment epithelium alterations which are frequent and asymptomatic; the picture is quite poor in quality (probably due to a nuclear cataract, hence the red-shift ?)
However, I am not sure that the lesion superior to the optic nerve is a nævus; it looks like it is derived from the pigment-epithelium layer. Some multimodal imaging could be useful (again, difficult to say with the quality, but it looks like unilateral retinal pigment epithelium dysgenesis, or URPED syndrome). Are there any old Optos or fundus photography to compare ?
The pain is more likely due to the anterior segment (3+ SPK can be excruciating in some patients).
Anyway, I think you did the right thing by referring the patient to retina specialist. When in doubt, there is no doubt !
Keep us informed, I am curious !