Steve Kelley

One of the most painful things to hear from clients with a vision loss acquired later in life is that they stopped using the computer or discontinued a lifelong passion for the newspaper or reading because of vision loss. It's painful to hear because there are so many options for accessing the computer screen or print, with or without sight.

Low-Tech Options

Let's start with a quick look at some devices that don't require a computer or smartphone.

Magnifiers

The simplest and often the most effective is a good handheld magnifier with a glass lens and a light built in. The best magnifiers are not going to be in your local retail store. Instead, you'll find them through a low vision doctor or vision rehab professional, like a vision rehabilitation therapist. These professionals can provide an assessment and let you know what type and magnifying power will be best for your vision. To find a professional, look up your state in the VisionAware Directory of Services. Once you know what you need, purchase through the professional or agency, or order online from a low vision retailer like LS&S Products or Maxi Aids. Another type of magnifier is the video magnifier, an electronic magnifier that is available in sizes from handheld to desktop units. Video magnifiers come with a variety of features and often have user-friendly controls. A video magnifier uses a camera to magnify text on a screen and can change the foreground and background colors to make it easier to read. Many can also convert the text into electronic spoken text and read the documents or text in the camera view. These vary in price from $400 or more for a handheld video magnifier to over $3,000 for a desktop video magnifier. Like the handheld magnifiers, you may want to check in with a vision rehab professional to see which features will most benefit you. These too can be found at both LS&S, MaxiAids, and other low vision retailers.

Reading Services

Other low-tech reading options include the National Library Service (NLS) Talking Books program, the National Federation of the Blind (NFB) NEWSLINE, and Radio Reading Services. NLS Talking Books, 1-888-657-7323, is a US federal program for anyone with a print disability, which can be accessed through each state's library service. Books are available in large print, audio, and braille formats. Audio books are mailed to patrons on cartridges that can be listened to on an easy-to-use electronic reader provided at no cost. When the book is finished, the cartridge is sent back to the library in a postage-paid shipping container. For patrons who use a smartphone, tablet, or computer, books can be downloaded and read on these devices using their BARD service. In Canada, the Center for Equitable Library Access (CELA) offers similar services, and can be reached by phone at 1-1-855-655-2273.

NFB NEWSLINE, 866-504-7300, is available in most states, and offers no-cost access to hundreds of newspapers and magazines. Like Talking Books, this service is available to individuals with a print disability. Subscribers can listen to their favorite newspapers or magazines by dialing an access number on their telephone and using the phone's number pad to navigate through the menus. This can be done with a landline or a smartphone. For more tech-savvy users, there are apps and Web services available to allow subscribers to download or get content delivered directly to their computers, pod catchers, or an Amazon Echo.

Radio Reading Services or Audio Information Services broadcast local and national publications over the air, like a radio station, over the internet, or both. The readers are often volunteers. For listeners who live within broadcast distance, a radio receiver might be provided, or the station may be received on your TV's secondary audio channel. Many broadcast over the internet, and are available through a computer, or by knowing how to ask for one on an Amazon Echo. To find an Audio Information Service, check out the directory on the International Association of Audio Information Services. For a list of those available with the Amazon Echo, download a list of Radio Reading Services on a Smart Speaker.

Bookshare is another excellent resource for accessible books and magazines. Books are downloaded to a computer, tablet, or smartphone to read, so users must have some proficiency with these devices. An annual subscription fee of $24-$50 is required for non-students. Students subscribe free. As a subscriber, there is no cost to download books and magazines (up to 100 books per month).

Reading Screens with Low Vision

Whether you are using a computer, smartphone, or tablet, there are most likely several ways to change the text size, magnify the screen, or use text-to-speech to read text out loud. The trick is to find out what accessibility options are on the device and which work best for the task at hand.

In addition to the accessibility options built into each device, there are often other apps or programs that may add more features. For example, a very popular screen magnification and text-to-speech program for Windows is Vispero's ZoomText, and a popular app for the iPhone or iPad is Microsoft's Seeing AI.

Here are some of the accessibility features found right on the devices you might be using.

Reading Print with Windows 10

Microsoft has dramatically ramped up their accessibility features in Windows 10. Microsoft's screen reader, Narrator, has been around for many years, but its updates in the last two years have made it much more robust. Narrator can be opened through the Ease of Access settings by pressing Windows + U, or by turning Narrator on with the keyboard shortcut Windows + Ctrl + Enter. This shortcut is a toggle that turns Narrator off or on.

As a screen reader, Narrator uses a set of commands to enable whatever is on the computer display to be read out loud. The screen reader also permits a high level of audio interaction with computer applications. For example, you can read a document and edit the document using text-to-speech.

While a screen reader may be useful in some situations for a low vision user, magnification with occasional text-to-speech may be a better fit. Like Narrator, Microsoft's Magnifier has undergone some significant changes in Windows 10, with one of the biggest being the addition of a Reading feature.

Windows Magnifier is turned on with the shortcut Windows + Plus Sign (+). With Magnifier on, the display is magnified and the Magnifier settings can be opened from the Task Bar. The Magnifier can be used in different modes, to magnify a rectangular portion of the screen that can be moved around, like a handheld magnifier, a docked rectangular portion of the screen, or full screen mode. Full screen is this writer's preference, but it takes some time to adjust to. The magnified view is of one portion of the screen, and to see other parts of the screen, the mouse pointer must be moved to scroll around the screen.

Regardless of the mode chosen, the magnification can be increased with the shortcut Windows + Plus Sign (+) or decreased with Windows + minus sign. In settings, the increment of change may be customized. By default, the increment moves by a power of one, so pressing Windows + Plus Sign (+) will increase the magnification by 1X.

As a screen magnifier user for many years, I've found that selecting the smallest increment of change, .25X, and using the mouse wheel combined with the shortcut Windows + Alt to increase or decrease the magnification provides the greatest flexibility. I will often change the magnification level frequently depending on the task, and this permits it to be done quickly with just the right amount of magnification.

With the magnifier turned on, text is easier to read visually, but because it is larger, and less is displayed on the screen, scrolling sometimes becomes necessary and there may be some eye fatigue with many vision impairments. This is where the new Reading feature becomes so handy. Unlike Narrator, the Magnifier reader has fewer reading options, but this makes it very easy to use. Ctrl + Alt + Enter will start and pause the reader, and pressing any key will stop it. You can select a starting point to read from by pressing Ctrl + Alt while pressing the left mouse button. By default, while the Magnifier Reader is reading, the word being spoken is highlighted in a blue rectangle.

The Windows Magnifier is not the only way to enlarge text on the screen. Digging into the Ease of Access Settings in Windows will turn up options to change font and icon sizes, customize foreground and background colors—all of which may improve the ability to read print on the screen. Overall, the Windows Magnifier provides the ability to quickly change display size, read text out loud with another shortcut, invert the colors, and add additional contrast. When the Magnifier is on, the keyboard shortcut, Ctrl + Alt + I, will toggle Invert Color off and on, so it can be used just as needed.

Reading Print on macOS

The Apple operating system, macOS, like Windows, has built-in accessibility features for accessing text more easily. To open the Accessibility menu, open the Apple menu, choose System Preferences, then select Accessibility. The macOS Accessibility options are similar to many of those found in the Ease of Access Settings in Windows, and include the screen magnifier Zoom, the screen reader, VoiceOver, and a number of other settings to customize the font size, contrast, and brightness of the display.

Zoom is enabled with the keyboard shortcut Option + Command + 8. Magnification can be increased with Option + Command + Equal Sign (=). Decreasing magnification is done with the shortcut Option + Command + Minus Sign (-). As mentioned above, with the Windows Magnifier, in Zoom settings, this writer set the magnification increments to a smaller setting than the default, and enabled screen magnification increases and decreases using the shortcut of Option + the mouse scroll wheel. This allows for quickly zooming in or out of something on the screen.

Apple's screen reader, VoiceOver, has been a solid full-featured screen reader for many years, with diehard fans. VoiceOver can be turned on using the keyboard shortcut Command + F5 or asking Siri to "Turn on/off VoiceOver." Like Windows Narrator, VoiceOver can be used with or without Zoom for reading, editing, and interacting with applications. While VoiceOver may be a great option for many low vision readers looking for a text-to-speech reader, MacOS contain a simpler text-to-speech feature in the Speech option, in Accessibility. Select the checkbox labeled, "Speak selected text when the key is pressed." The default shortcut is Option + Esc. To use this feature, text is first selected, then read using the shortcut keys. In the Speech settings, various voices may be selected and the speech rate customized.

One of the handiest features for those needing greater contrast on the display, is Invert Colors. This can be enabled in the Display Settings in Accessibility. Some users will find the keyboard shortcut Control + Option + Command + 8 will toggle this off and on, as needed. If this doesn't work on your computer by default, go to System Preferences and open the Keyboard Settings. Choose Accessibility, then enable the shortcut for Invert Colors.

Accessing Print on Apple iOS (iPhone, iPad, and iPod Touch)

Like Apple's laptop and desktop computers, Apple's tablets and phones using the mobile iOS operating system have accessibility features built in, and can be enabled from the Settings menu. iOS includes a screen reader called VoiceOver, a screen magnifier, Zoom, and numerous other features to increase the font size and add contrast to the display.

VoiceOver in iOS provides complete access to the device with text-to-speech. Like VoiceOver on the Mac, and Narrator on Windows, there is a bit more of a learning curve because of the many gestures used to operate all these features. VoiceOver can also be used with the Zoom magnifier to provide spoken text for the low vision user who may only need a screen reader from time to time. VoiceOver can be quickly turned off and on using Siri, "Turn VoiceOver on/off," or by pressing the Power button three times quickly (if the phone has a Home button, press the Home button three times quickly instead of the Power button).

iOS also includes two other features for text-to-speech that are very useful for the low vision user. In the Accessibility Menu, open Vision, then Spoken Content. Find Speak Screen and Speak Selection. Both features enable text-to-speech as needed, with fewer features and a shorter learning curve. Speak Selection adds a menu option to those shown when text is highlighted. Choosing Speak from the menu options provided when text is highlighted will read the highlighted text. Speak Screen, when enabled, reads text from the top of the document to the bottom, with a two-finger swipe down the screen. A dialog box opens when speech is started to play or pause the speech, move forward or backward in the document, or change the rate at which the document is read. The dialog box with the controls minimizes after several seconds to a small icon on the side of the document that can be reopened, as needed, to access the controls again.

Both Speak Screen and Speak Selection are ideal if you primarily navigate the phone visually, and prefer a quick text-to-speech option for reading text. Speak Screen and Speak Selection have fewer text-to-speech options and are easier to use in some ways then VoiceOver. For example, VoiceOver has all the features needed for editing a document—reading line by line, character by character, a key echo when typing and so much more. Speak Screen and Speak Selection offer very basic text reading functions, which for many reading tasks will be far more efficient than reading visually.

In addition to the Accessibility Settings in iOS it's worth mentioning the Magnifier app, built into the latest versions of the iOS operating system. This app provides many of the features found on a handheld video magnifier. Text viewed through the camera can be increased or decreased in size, and the colors of the foreground and background optimized for better contrast.

Lastly, third-party apps, like Microsoft's Seeing AI or KNFB Reader make printed text much more accessible. Using the camera, print is converted into electronic text, which can then be read out loud. With these apps, sections of a book, magazine articles, business documents, and more, can be quickly read, in many cases more easily than using a handheld magnifier.

Reading Print with Android

Tablets and smartphones using the Android operating system also have some really powerful accessibility features built in. Because Android is an open source operating system, different phone manufacturers will provide different features on their phones. The full-featured screen reader on Android is TalkBack. Like VoiceOver, it provides text-to-speech features throughout the device and many apps.

For the low vision user needing extra magnification in the screen display, the Accessibility menu in Settings provides Magnification, Magnifier Window, and a variety of other options increase and decrease font size, and enhance color preferences for better contrast. With the Magnifier enabled in Settings, for example, a triple-tap to the screen will magnify the screen, and a pinch gesture will increase or decrease the magnification on the display.

For text-to-speech reading, TalkBack can be enabled, with or without magnification, using the shortcut of pressing both the volume up and down buttons at the same time for about three seconds, or using the Google Assistant to turn TalkBack on, "Hey Google, turn TalkBack on" (it should be noted that this feature stopped working with the last operating system update, and will presumably be fixed at some point in the future). TalkBack, like the other screen readers, has many features and provides full text-to-speech access to the device. All these features, of course, mean a bit of a learning curve for the low vision user, who may just want simple text-to-speech for efficiently reading an email or webpage.

One feature, Select to Speak, may be enabled in the Accessibility Settings. Select to Speak provides a small icon on the lower right corner of the screen, when added to the Accessibility Menu. Touching this icon opens a menu with a Play and Stop icon. Press Play, and the screen is read from top to bottom. The menu can also be expanded to access a Settings icon, where settings may be customized for speech rate and pitch. Keep in mind, Select to Speak has fewer features than TalkBack, so it's of no use for editing. When Play is selected, a menu opens to Pause and Skip forward or backward in the text.

Although it is not built into the Android operating system, the Voice Reading app, when installed, enables more selective reading, much like the iOS Select to Speak feature. Highlight text to read, select Share from the menu, then choose the Voice Reading app from the list (you may initially have to add Voice Reading to the list of apps that text can be shared with). The advantage of Voice Reading over Select to Speak, is that Select to Speak reads everything from the top of the page to the bottom, and Voice Reading lets you choose the text to read by highlighting it.

There are several apps available for Android that can make print much easier to read. Lookout by Google, works in much the same way as Seeing AI, with options for reading short bits of text as the camera is moved over print, or to read an entire document. Speak! too will process and read back a document and reformat it into high contrast large print text on the screen (see AccessWorld's comparison of Speak! and Envision AI](https://www.afb.org/aw/20/8/16738) in the August 2020 issue). Both LookOut by Google and Speak! are free apps.

Reading Print Again

This really just scratches the surface of the many options available for reading with low vision. Reading and using computers, phones, and tablets with a display presents a unique challenge for the user with a vision loss acquired later in life. Chances are, prior to the vision loss, you used few, if any, of the accessibility features or reading services described in this article. In fact, you may not have even heard of any of them. Like any adaptation or new skill, these features may take a bit of practice and some patience, but the bottom line here is that whatever your vision, you can get back to reading print, and to using your smartphone and computer with some of these low vision accessibility features. Best of all, you'll find many built right into the devices you have at home.

This article is made possible in part by generous funding from the James H. and Alice Teubert Charitable Trust, Huntington, West Virginia.

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Author
Steven Kelley
Article Topic
Education Matters