Wow...you've got a lot of things here. Let see if I can narrow this down to a list.
1. refraction problem (myopic astigmatism)
This can be sorted out with glass prescription. The change in refraction from -1.25 to -2.75 can be from cataract.
2. macular degenration (age related change to the central vision portion of the retina)
In the early portion of this condition you should consider taking AREDS vitamins (this has beta carotene or lutein, vit C, vit E, zinc). You should have annual dilated eye exams. Discourage smoking. Vision would have distortion to central vision and not things floating around. This distorition would be when the macular degenration changes from dry form to wet and typically is found in older individuals. Unlikely in your situation but remember I haven't had the luxury of examining you.
3. Floaters in your vision
This is most commonly from vitreous synerisis or a vitreous detachment both of which are typically observed and not treated as they rarely have serious vision threatening comlication in the long run.
4. Narrow angle
this is when the iris insertion is in close proximety to the corneal angle making it harder for the fluid in the eye to exit. It can cause elevated eye pressure, eye pain and can damage the optic nerve if the angle was to close. Prevention of the closure is done with a simple iridotomy that is performed with a laser. Individuals do very well with procedure.
It seems that you have cataract changes, mild macular degeneration, narrow angles and refractive changes. The cataract changes for a 44 year old would make me want to know why the cataract is there? Steroid use, trauma, previous infections, uveitis. If you do have a cataract is plausible that the cataract is enlarging thus pushing on the iris and thus causing the narrow angle. If this were the case, I'd perform a laser iridotomy to prevent closure and then do cataract surgery.
Without having seen you myself, it makes it hard for me to definitively tell you whats going on.
narrow angle doesn't just appear spontaneously. it comes on insidiously and requires a goinioscopy to diagnose. thus the clinicXXXXX XXXXXkely did this due to suspicion on examination. it's fairly easy to treat and is important to treat to prevent the angle from closing completely which could lead to severe eye pain, corneal swelling and decreased vision. if treated the likelyhood of complete angle closure is unlikely.
as for the pinguecula, just observation is needed, to prevent progression just wear sunglasses when in sunny conditions. you can use natural tear drops to help if there is discomfort. typcally these are benign and not a problem for patients.
as for the sinuses. it is possible but would typically have pain over the sinus and feel sick, have difficulty breathing and have prior history of sinus disease.