- The problem of orienting moduli spaces of pseudo-holomorphic discs with totally real boundary conditions is really a problem in index theory. It was solved Vin de Silva in his (unpublished) D. Phil. thesis, using Atiyah's Real K-theory, and independently by FOOO. There's an excellent account in Seidel's book (section 11).
A totally real Cauchy-Riemann problem is by definition a loop in the totally real Grassmannian $\mathrm{Gr}(V)$ of a complex vector space $V$ with a given real structure. The resulting space $L\mathrm{Gr}(V)$ parametrizes a family of Fredholm operators (the Cauchy-Riemann operator for functions on the closed disc, valued in $V$, with boundary conditions specified by the loop). Hence there is a determinant index bundle $$\underline{det} \to L \mathrm{Gr}(V),$$ and the basic orientation problem is to describe $w_1(\underline{det}) \in H^1(L \mathrm{Gr}(V);\mathbb{Z}/2)$. For the component $L_k\mathrm{Gr}(V)$ of Maslov index $k$ loops, $H^1(L_k \mathrm{Gr}(V);\mathbb{Z}/2)$ is 2 dimensional, as one calculates using a homotopy equivalence $\mathrm{Gr}(\mathbb{C}^n) \simeq U(n)/O(n)$, so there are just four possible answers to the orientation question for each $k$.
The answer is simpler to state assuming $k$ is even. It is then as follows (I learned this from de Silva's thesis): Take a loop $\gamma\colon S^1\to L_k\mathrm{Gr}(V)$. Then $\langle w_1(\underline{det}), \gamma\rangle = \langle w_2, T_\gamma \rangle$, where $w_2$ is the second SW class of the universal totally real bundle on $\mathrm{Gr}(V)$, and $T_\gamma\colon S^1\times S^1\to \mathrm{Gr}(V)$ is the torus of boundary values swept out by $\gamma$.
So, in a space of pseudo-holomorphic discs in a symplectic manifold $X$ attached to an orientable Lagrangian $\Lambda$, $w_1$ of the determinant bundle evaluates on a loop $\gamma$ by evaluating the torus of boundary values $T_\gamma$ on $w_2(T\Lambda)$. Essentially for this reason, it's natural to trivialize the determinant bundle by trivializing $w_2(\Lambda)$, i.e. specifying a Pin structure (though this isn't quite right because $TX$ isn't trivialized; one actually needs a Pin structure relative to $TX$). This is perhaps the only uniform way to orient moduli spaces of pseudo-holomorphic discs.
For Cauchy-Riemann operators on other curves, one can degenerate to a nodal union of discs and closed Riemann surfaces, combining the orientations for the space of discs with the complex orientation of the determinant line bundle over the moduli of closed curves. Thus no additional obstructions to orientation appear. Technically, one is using the excision properties of elliptic operators.
I don't know, but there are further concrete calculations for real loci in the work of Welschinger and also Solomon.