Recent changes / wishlists are one of the very few interfaces that offer no pagination or other way to access older results, even though at the API level the functionality exists.
The best UI for this would probably be the type used on Special:Log and Special:Contributions. The Allpages/Prefixindex next/prev, and the TablePager big blue buttons are more for alphabetical listings and tabled/columned lists. The UI could just add inside the existing form:
(latest | earliest) View (newer 50) (older 50) (20 | 50 | 100 | 250 | 500)
This isn't ideal for a recent changes field (where the tail end of the information is trimmed), but it is already used by Special:Newpages so should suffice.
See also