Series: Computing for the Visually Impaired
Mariva H. Aviram explores visual impairments and how they cause problem for computer users, which, let’s face it, is just about everyone today.
Article 1 of 5 in series
In the first part of our series on computing for the visually impaired, Mariva H. Aviram discusses working around her own temporary visual impairments, as well as the challenges faced by those she knows.Show full article
If you have fully functioning eyes, conduct a thought experiment on how you would navigate your life without them. How would you earn a living, keep up your home, maintain personal hygiene, take care of your loved ones, and transport yourself from one place to another?
Now reduce the experiment to just one significant area of your life: digital data. How would you communicate with people, access your personal information, pay your bills, track your finances, and submit your work? Even for those of us whose jobs don’t involve computers — which is increasingly rare — much of our lives involves electronic screens and digital data. For “knowledge workers,” computers are integrated into the things most important to them: work, identity, creativity, and connection.
Viral Conjunctivitis and My Terrible, Horrible, No Good, Very Bad Weeks -- In the spring of 2014, my left eye began exhibiting the symptoms of a particularly severe case of viral conjunctivitis. Within the space of 36 hours, the area around my eye swelled to the size of a golf ball. After at least 12 hours, when I was finally able to crack open my eyelids, the garish rainbow colors of my lumpy, swollen conjunctiva (the clear membrane above the sclera — the white part of the eyes) shocked me and both the acute pain and my unremittingly blurred vision frightened me.
(For more details of the Lovecraftian horror of this particular experience, search for “epiphora,” which was voluminous, and for “purulent exudate” (you do not want to browse through Google Images results for those searches). Thankfully, I was fortunate enough not to have grown new membranes over my conjunctiva, which is apparently symptomatic of even worse cases than mine.)
During the first few days of physical and emotional trauma, I was consumed by anxiety over my growing pile of undone tasks and chores, and then by the sheer boredom of attempting to occupy my mind while my eyes remained closed. Even setting up a series of podcasts to listen to would have overtaxed my good eye. After a week or so, I faced the daunting challenge of figuring out how to use a computer — or any screen. I had never fully appreciated how crucial, yet fragile, eyes are.
To deal with my sundry visual frustrations, I made as many adjustments as possible. For example, I stopped wearing my prescription eyeglasses. I found my uncorrected vision to be workable when using an iPad, but much less so with the MacBook Pro. My good eye had to compensate for my infirm eye, and so the good eye ended up doing most of the work of both. However, keeping my bad eye closed while my good eye darted around the screen rapidly led to eyestrain.
The iPad screen seemed too bright even at its dimmest setting and, unlike with a traditional computer, there aren’t numerous screen adjustment utilities. (After the fact, I found Dimmer, which received mixed reviews, as well as several third-party Web browsers with screen-dimming features.) Due to extreme photophobia, I wore dark sunglasses while viewing the computer screen, even while it was fully dimmed. To make matters worse, the polarized lenses created additional visual interference.
Statistics on Visual Impairments -- One question arose in my mind: How do people do this? Surely I can’t be the only visually impaired computer user who needs to get things done.
According to a 2012 CDC survey, outlined by the American Foundation for the Blind, 20.6 million American adults reported experiencing vision loss — which is close to 9 percent of all adults in the United States; those with actual visual disabilities comprise about 6 million adults. This increases exponentially as people age. Worldwide, 285 million people are estimated to be visually impaired. Since the use of digital screens is such an integral part of modern life, these statistics are significant for tech developers and other intensive computer users.
It’s important to realize that visual impairments, and sensory deficiencies in general, can differ greatly from one person to another — and even from one eye to the other within the same person. From a product development perspective, it’s difficult to design adequate interfaces to accommodate different needs, especially since each user requires unique solutions and adaptations.
My own impairment, which left me with only one good eye — which was also hampered by photophobia and eyestrain — presented one set of challenges. Here are three other cases to consider.
Optic Nerve Damage from Meningitis -- My brother, a senior software engineer, suffered damage to the optic nerves in both of his eyes from a bout of meningitis twenty years ago. As a result, he has blind areas that are different in each eye. These blind areas are not totally impervious to visual input, but his visual acuity in those areas is inadequate to read or recognize sharp outlines — except in one small center of vision in one eye, which he relies on to read, find a mouse pointer, and perform other tasks involving fine visual details. Upon recommendation by the Vision Rehabilitation Center at the Massachusetts Eye and Ear Infirmary, he sets backlit screens to a very high level of brightness to ease reading and discerning fine detail.
In order to fit a readable amount of text into the one precious area of clarity within my brother’s eye, the type must appear as small and sharp as possible. (To this end, a “reducing glass” — as opposed to the commonly used magnifying glass — would be ideal.) For larger images, he relies on peripheral vision. This inconsistency makes annotated images such as diagrams particularly troublesome.
With these competing limitations, he encounters numerous frustrations with computer screens. If, due to time constraints (such as while giving a presentation), he cannot increase the pointer size, he simply mouses to the upper left corner in order to find the pointer, repeating this every time he “loses” the pointer. Moving his eyes away from an area of focus and back is especially disruptive because of the difficulty in finding his original place. Another big time-waster is searching through a Web form to find a field or the submit button. Keyboard shortcuts often circumvent these problems and, as an added benefit, streamline procedures.
Some arcane problems present themselves only during unusual circumstances. For example, the mouse trails feature in Windows can be useful, but only when working in Windows natively. When running Windows in VMware Fusion, the refresh rate is too slow, which renders the mouse trails in disorienting and distracting ways, with the mouse cursor seeming to flash within an area without its usually beneficial precise pointing.
Finally, solving one problem — such as inverting colors to ease the reading of text — sometimes creates another, such as also inverting colored images, which makes people appear as “ghouls and ghosts,” gives desktop wallpapers unpleasant hues, and makes many diagrams unreadable. Or, the mouse pointer, when increased in size, covers text and icons just when they need to be most visible. You can imagine the frustration.
Dry Macular Degeneration Causing Excessive Sensitivity -- In contrast to my brother, who requires bright displays to see his work, I have a friend who is very sensitive to the brightness and contrast of LCD screens due to suffering from the early stages of dry macular degeneration. When he views a monitor straight on, he describes looking up at it “through his eyebrows” — meaning that he uses his eyelids to cover the pupil partially in order to create a pinhole-view effect. He blocks out much of the screen, focuses on just a line or two of text, and then looks down again.
His solution to the excessive brightness is to dim his screens with the free utility Shades, which competently manages multiple monitors. He also views monitors from above, which throws less light into his eyes. Nevertheless, he still experiences some artifacting, which can be distracting, particularly with a Twitter or mail client that has subtle background colors to indicate message status, Web page text with blue links that seem to cast a yellow haze around everything else on the page, and light text on a dark background that produces ghosted images of lines.
With regard to vision, my friend talks about making hard choices: not just with what he’s going to do, but with what he pays attention to — and even when he opens his eyes and for how long. “You have to choose what you’re going to look at,” he says.
Living in a Colorless World -- Another acquaintance, a former software engineer whom I’ll call “Roy” (with a background in, of all things, information visualization and graphical display of complex data), is severely colorblind due to a rare eye disease called incomplete achromatopsia, or dyschromatopsia. In dim-to-medium indoor lighting, he sees only in grayscale. With increasing illumination, he can discern colors from the red to the blue end of the color spectrum. But as illumination increases, details become harder to see. He can’t discern washed-out or pastel colors under any conditions, and he claims that he “fails every standard test of color vision miserably.”
Roy has poor visual acuity — he is legally blind in typical illumination conditions — even with his prescription eyeglasses. In addition, he suffers extreme sensitivity to light, which renders him nearly blind in sunlight if he’s not wearing specialty dark glasses with side shields. He also wears a hat or visor to block stray light from above. All of these symptoms and experiences are typical of incomplete achromatopsia.
(AchromaCorp is currently the only organization that specifically raises funds to develop treatments and cures for achromatopsia. For the cautiously optimistic, medical research group AGTC may begin conducting human trials within two years for a workable gene therapy to treat achromatopsia and other eye diseases.)
With regard to computer use, like many low vision users, Roy makes do with what he has. His primary operating system is Windows XP. He sets the style to Windows Classic, because the blue-and-green Luna visual style is “too visually cluttered and confusing.”
The bane of many a Windows user’s experience is Microsoft Outlook, and that’s no different for Roy, especially after Microsoft changed one of its key design features of Outlook. In previous versions, unread email appeared bolded. The color scheme now distinguishes read from unread mail with what appears to him to be “slightly different shades of gray, and in the same font, size, and boldness,” making it far more difficult for him to differentiate between types of messages.
Similarly, with the Outlook calendar, the color that distinguishes the Today box is almost the same brightness as the color of the appointment rectangles, which makes them difficult to distinguish for those suffering from color blindness.
Roy observes an increasing use of color coding to convey information that had formerly been conveyed via simple text or other graphical conventions. His coping strategy is to spend more time trying to discern what are to him the subtle differences in visual cues.
One positive recent trend in graphic design, however, is the “flattening” of icons, buttons, and other elements — a look-and-feel change that’s pronounced in iOS 8 and OS X 10.10 Yosemite — because it allows more of the screen real estate to be used for clearer images and larger text rather than for nonfunctional elements, such as 3D border shading or color gradations.
When viewing Web sites Roy simply enlarges the browser text as needed. Some Web sites, however, choose color schemes that render sites inaccessible for colorblind users. (Terrible palettes include blue text on a green background, yellow text on a blue background, red text on a black background, and any text on a busily patterned background.) If Roy needs to read such a Web site, he must highlight the text to do so.
Because of his light sensitivity, Roy reduces the backlight brightness to the lowest setting, but sets the contrast high. This is a paradox, though, because higher contrast also increases brightness, so it’s a compromise. He also sets the screen to a low resolution of 1024 by 768, which enlarges text to make it readable for him.
Roy doesn’t have a particular font preference, but text size is important. For composition, he sets the font size to around 20-point type (Arial), which is on the low end of ease of use for him. For reading long documents, such as ebooks, he sets the font size to approximately 36-point type or more.
When I first discussed this topic with him, Roy summed up the problematic recent design trends thus: “Computing is getting harder for people like me because users are expected to do ever more with ever smaller screens.”
Avoiding small screens altogether is becoming less of an option. These devices — which rely on minuscule font sizes; small, highly detailed icons, color coding; and visual clutter — are increasingly displacing traditional, more accessible media (print maps, business cards, landline phones), leaving those with poor visual acuity at a disadvantage. Even apps that enable zooming and scrolling are clumsy and time-consuming.
“These products aren’t designed by or for elders or for those with any kind of visual impairment, such as color defects or ambient light interference,” he laments. As a result, he doesn’t own a mobile phone.
Also, disabled people suffer much higher rates of crime victimization than the able-bodied (and the able-visioned). Roy feels particularly vulnerable to street crime because of his low vision and the dark glasses that block his peripheral vision. The proliferation of expensive mobile devices has exacerbated theft and related crimes in high-density areas, disproportionately harming people with low vision and other disabilities.
Preparing for Visual Impairment -- I figured that there must be some help for people like me, and there is, to some extent. In hindsight, of course, the best time to have learned about such options was before I found myself disabled.
Preparing for the loss of vision is like disaster preparedness; most people don’t want to think about it. You hope that you’re never in such a situation, but if you are, you’re glad that you did at least some preliminary work to prepare. Familiarity with Accessibility preferences and third-party utilities is akin to installing quality, regularly inspected smoke detectors and fire extinguishers around your home.
While coping with my own affliction, I was inspired to learn more about other people’s experiences with visual impairment as well as about remedies and assistive technologies for people like us. In the next installment of this series, I’ll explore a variety of eye problems and share the advice of vision care experts.
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Article 2 of 5 in series
In the second part of our series on computing for the visually impaired, Mariva H. Aviram discusses various visual problems that can affect computer users.Show full article
In Part 1 of this series (see “Computing for the Visually Impaired, Part 1,” 9 January 2015), I described several people’s experiences with visual impairments, as well as my own experience with temporary eye disabilities. Enduring such an acute trauma gave me empathy for my fellow low vision users — as well as fierce determination to learn more about what can go wrong, both clinically and for those with “normal vision.”
When accounting for the various types of visual impairments, one must understand the physiology of the eye in order to predict what can go wrong with it. For example, my impairment stemmed from inflammation of the conjunctiva (the thin membrane that lines the inside of the eyelids and covers the sclera). Damage to the optic nerves caused my brother’s impairment, whereas my friend’s problems were caused by crystals forming on his retinas. Finally, my acquaintance Roy’s achromatopsia stems from malfunctioning cone cells (the retinal cells that detect color).
In other cases, glaucoma can also damage the optic nerves, cataracts cloud the lens of the eye, and corneal abrasions can cause pain, blurred vision, and photophobia. If a user is limited to the use of one eye, asthenopia (eye strain) can result from taxing the muscles in and around the remaining good eye — and, although not typically relevant to computer use, three-dimensional perception is lost. (To prevent asthenopia, refer to Lighthouse International’s “Tips for Preventing Computer Eye Strain.”)
Some degenerative eye diseases, such as retinitis pigmentosa, can gradually degrade even perfect vision to near or total blindness. The tragic but ultimately inspiring story “What It’s Like to Slowly Lose Your Eyesight” describes one woman’s journey through this process.
Other common types of visual impairments include extreme nearsightedness or farsightedness that is difficult to correct with prescriptive lenses; hypersensitivity to even slightly imprecise prescriptions (this is a problem for me even when I’m not suffering from a serious visual impairment); artifacting such as floaters, flashes, or ghosting; colorblindness; contrast sensitivity loss; and continually dry or irritated eyes.
My highly competent and affable ophthalmologist Dr. Benjamin B. Bert explained, “because of all the subtle differences even within particular diseases, each person may need to use different coping mechanisms.” This is one of the sub-specialties in the field of vision care known as [Low Vision][rewrite17]. Low Vision practitioners work very similarly to occupational therapists, with a focus on the eyes.
[rewrite17]: http://www.iapb.org/vision-2020/what-is-avoidable-blindness/low vision
Risks for “Normal Vision” Users — Even without serious visual impairment, “normal vision” users are susceptible to some common risks associated with sustained computer screen use.
According to my optometrist, Dr. Stewart F. Gooderman (whose precision in lens prescription is unparalleled), the most common visual problems that interfere with computer use include “uncorrected binocular deficits and deficiencies in tear film construction and maintenance.”
Fortunately, simply requiring prescription lenses isn’t enough to cause problems. Dr. Gooderman says, “Corrected optical errors like nearsightedness, farsightedness, astigmatism, and presbyopia have relatively little effect if the optical device to correct for it is properly chosen and used.” In addition, “[Poor] binocular eye coordination — the inability to use both eyes efficiently as a team — causes far more problems because computer work is more meticulous and lasts longer than other tasks.
And the task itself is being shown to have a detrimental effect on the tear film. Without a good tear film, visual clarity is simply impossible.” (For those with binocular deficits, Dr. Gooderman recommends vision training and therapy with an optometrist who specializes in binocular vision.)
Dr. Bert emphasizes that the majority of eye problems encountered with computer use result from a breakdown in the tear film, which has three layers:
A lipid (oil) layer on the exposed surface that helps prevent evaporation
An aqueous (liquid) layer in the middle
A mucinous (mucous) layer closest to the eye (adjacent to the corneal surface)
Dr. Gooderman explained that under normal circumstances, lid blinking refreshes the tear film and reestablishes its proper configuration. During computer use, however, the blink rate reduces drastically from the average rate of twelve times per minute. This produces a double detrimental effect, with one exacerbating the other. First, without the proper refresh, the tear surface breaks down and impairs the pristine optical surface that the eye needs to bend light properly — because the cornea itself does not have a smooth surface. The cornea needs the tear film to fill in the irregularities.
The second effect is that the lack of blinking prevents the massaging of the oil glands in the eyelids, which is necessary to distribute oil onto the tear film’s surface. Without this massage, oil builds up in the glands, creating inflammation and swelling, which can seal off the exit ducts of the glands. This can eventually cause the glands to degenerate. Eye care specialists refer to this condition as chronic evaporative tear disease; without that oil, the tears evaporate much faster and the normal tear structure is no longer supported. This condition has recently been noticed because young people are starting to exhibit the tear film and oil glands of post-menopausal women, who more commonly suffer from tear film damage.
Dr. Bert expounded on the breakdown of the tear film, which affects both comfort and vision. “The tear film is the first thing that light hits as it is entering the eye,” he said. So, with an irregular tear film, or with areas of dryness, the tear film diffracts, rather than refracts, the light. A healthy tear film is like a plate glass window, whereas irregular tear film is more comparable to a frosted glass window. Frosted glass produces much more disruption of a point source of light and, in the case of a damaged tear film, glare as well.
Aging can intensify the problem with the common onset of blepharitis, which affects the meibomian glands that produce most of the oil for tears. If the lipid layer is compromised, tears evaporate more quickly. In addition, when using a computer, driving, watching TV, reading, or performing any other intensive visual task, the blink rate decreases. Dr. Bert compares this to engaging in a staring contest with an inanimate object. “As we all know,” he quipped, “the inanimate object always wins.”
To protect the tear film, Dr. Gooderman recommends looking away from the monitor every 20 minutes and consciously blinking for one minute; regular breaks are crucial. You can experiment with break-reminder apps and combining eye-blinking breaks with walking around at least once an hour, which, tangentially, is vital for cardiovascular health.
In addition, Dr. Gooderman and Dr. Bert recommend liberal use of supplementary ocular lubricants (“artificial tears”).
Dr. Bert points out another risk: an accommodative spasm, which can occur with prolonged “near activity,” such as reading print material or viewing computer or smartphone screens. While uncommon, an accommodative spasm causes the eye muscles that focus on a “near object” to spasm and fail to relax. An accommodative spasm can blur distance vision and cause eye pain, nausea, and headaches. As with preventing tear film damage, Dr. Bert recommends frequent breaks and looking at a distant target at least once an hour.
Computer Vision Syndrome — If computer use is wreaking havoc on your eyes, you’re not alone. In fact, eye care specialists so routinely treat computer-related vision problems that they’ve dubbed the related issues “Computer Vision Syndrome” (CVS). Symptoms of CVS include general discomfort, such as headaches and neck and shoulder pain, as well as specific eye woes (burning, tired, and red eyes, as well as twitching eyelids) and visual impairments (loss of focus, double vision, and blurred vision).
Although nascent, CVS is a growing field of interest among eye care specialists. For example, the Pacific University College of Optometry hosts conferences with topics such as “Optimizing Text Legibility and Readability,” “Measuring Visual Performance and Comfort,” “Vision and Workstation Design,” and “Vision Corrections and Interventions for Computer Users.” My hope is that the conclusions from this research will soon make their way into public knowledge.
If dealing with my ocular crisis and its resultant vision loss made me feel helpless, then learning about how the eye works has been somewhat empowering, at least from an academic perspective. In the next installment of this series, I’ll detail the myriad common obstacles and frustrations that low vision users encounter during typical computer use.
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Article 3 of 5 in series
In the third part of our series on computing for the visually impaired, Mariva H. Aviram discusses the numerous annoyances and technical inadequacies of our modern operating systems for those whose vision isn’t perfect.Show full article
Learning about the physiology of the eye gave me insight (so to speak) into the causes of visual impairments. In “Computing for the Visually Impaired, Part 2” (19 January 2015), two eye care practitioners weighed in on the importance of maintaining a healthy tear film, which requires conscientious attention to the mundane task of regular blinking. This is especially important during the intensive computer use that is notorious for engendering poor eye health habits. Now I’ll shift the focus to the myriad obstacles that visually impaired users face with computer operating systems and software interfaces.
My temporary visual impairment exacerbated the everyday frustrations that I experience while using computers and smartphones. Without a visual impairment, I could dismiss these low-level frustrations without thinking. If dealing with the constant annoyances of typical computer use is like waving away a gnat, attempting to navigate the same systems while disabled is akin to negotiating with a swarm of wasps. My list of complaints was (and is) legion:
I discovered the classic Catch-22 of accessibility management: in order to experiment with Accessibility preferences, I first had to navigate to and through them successfully, which proved difficult — because all computer use became difficult.
Before I installed a third-party screen-dimming app, the dimmest brightness setting was still too bright. And screen-dimming apps, while they do generally alleviate discomfort, should be improved in terms of choosing which areas or colors to dim and which to leave as is. Ideally, I wanted the whites less bright and the darks to stay the same.
Magnifying the screen worked well until I had to view portions of the workspace that were cut off at the edges. I also learned that it’s impossible to enlarge the view of a single desktop space; magnifying the screen enlarges the view of all spaces (even on multiple displays). It would be nice to enlarge text in one space and view images normally in another, for example.
If I enlarged the pointer to a usable size, I found that the text cursor was then too big — and the spinning rainbow was huge! In addition, the enlarged pointer counterproductively covered text and icons, and it was an exercise in imprecise guesswork to click tiny icons, such as disclosure triangles. (I finally figured out that I needed to aim for the top.)
It was frustrating trying to locate non-standard placement of buttons in dialog boxes, buttons that move around unpredictably, and the close button of Web page pop-ups. Perhaps irrationally, I started taking inconsistent design as a personal affront.
I grew increasingly infuriated with anything flickering or moving unnecessarily on Web pages: animations, ads, rotating article click-bait, bouncing icons, blinking or flashing text, and so on. (After verifying that pop-ups were turned off in the browser preferences and installing the Ghostery extension, I found myself simply covering animations with floating window Stickies set to a neutral gray color.)
Web sites inundated me with too much information, arrays of unnecessary cruft, and too many things to look at and read — a recipe for eyestrain in my good eye. (I avoided visually noisy news sites and social media networks altogether for several weeks, which turned out to be a nice break. Just the idea of Pinterest brought me anguish.)
Various bugs, glitches, and inscrutable error messages sent me into psychological spirals of despair.
Bear in mind that these problems arose during light computer use; I wasn’t using complex software (such as graphic design or audio production apps) or attempting to accomplish anything extraordinary. What should have been simple tasks of navigating the Mac OS interface and reading text-centric Web sites were often too difficult and frustrating to justify the effort.
Web Forms -- My brother shared his frustration with poorly designed Web forms. Web forms — like all other interfaces — should be fully keyboard accessible. “A well-designed form,” he said, “should enable me to tab from field to field, and press Shift-Tab to navigate backward through previous fields. Unfortunately, the default behavior of Safari and some other browsers is to tab only through text fields, [skipping] checkboxes, drop-down menus, radio buttons, etc., forcing me to use the mouse.” (Luckily, you can control browser tabbing behavior in each browser’s Advanced preferences.)
Very often, after submitting a form, I find that the application rejects it on a first try because I am missing some item. This generally happens when the form is not so well organized as to make the location of each successive field predictable. Then, the worst situation is when I cannot find the error message, or the error message just says something like “You must complete all the fields” — and then I have to pore over the form, over and over, looking for the field with the missing entry, perhaps annotated with some tiny red text. It would be much more helpful if the error message were in bold text at the top, perhaps on some special background to set it off, and if it specified exactly which field lacked the necessary data.
With such Web form problems, browsers might be able to provide the solution. Just as Safari provides a simplified Reader view of text-heavy Web pages, perhaps browser developers could also provide a simplified Web Form view that would lay out all of the fields of a form in a vertical row, enlarge the Submit button at the bottom, bold error text as described above, and highlight the problematic fields.
Lack of Options — As many Accessibility options as there are, we can always use more. For example, if the operating system and app designers provided the option of color-inverting just text — or text and dialog boxes, or everything (text, dialog boxes, images, menu, Dock, and background) — that would change the adaptive experience enormously. And how about offering users colorblind-friendly palettes?
Also, if a “reducing glass” isn’t in high demand, as I suggested in “Computing for the Visually Impaired, Part 1” (9 January 2015), then the capability to reduce text size well below the currently smallest setting could be effective. For example, the smallest size of text that Safari allows is 9-point type.
Why this arbitrary lower limit? There’s no good reason that Safari can’t allow 8-point, 6-point, or, for those with Retina displays, 4-point text. Better yet, make it a field so that a user could enter any text size.
Still other users need greater contrast controls, different text sizes and fonts, and a full spectrum of colors adjustments (not just simple inversion).
iOS Annoyances -- Mobile devices present their own challenges. For example, iOS apps continually interrupt me with obnoxiously timed requests to rate and review them. This should be a toggle setting in the General preferences. I’ll rate iOS apps when I want to, not when I’m “reminded.”
More commonly, composing text without a tactile keyboard isn’t easy for anyone, although many of us are used to it by now. (The keyboard and magnifying loupe on the iPhone was so problematic for the illustrious Andy Ihnatko that he switched to Android.) For visually impaired users, though, flipping back and forth between the keyboard and the text field without losing one’s place is an exercise in not losing one’s mind. (A physical keyboard case might help, especially with the problem of navigating through text.)
To circumvent the cursor-and-loupe rigamarole, Apple added right- and left-arrow keys (though not up- and down-arrow keys) to iOS 8, but only in landscape mode on the iPhone 6 and 6 Plus. In addition, arrow keys are also available in some third-party keyboards — and some text editors provide their own custom cursor keys.
Having said that, I do appreciate the improved QuickType keyboard in iOS 8 and the option to install alternative keyboards (see “iOS 8 Third-Party Keyboards Explained and Reviewed,” 2 October 2014). (By the way, Yosemite has a new QuickType-like feature that can help when composing text on a Mac.)
Blind Users Study -- According to the Towson University study “What Frustrates Screen Reader Users on the Web: A Study of 100 Blind Users,” the top causes of frustration among visually impaired users are:
Page layout causing confusing screen reader feedback
Conflict between the screen reader and application
Poorly designed or an unlabeled form
No alternate (“alt”) text for pictures
A three-way tie between misleading links, inaccessible PDF, and screen reader crashes
The study also calls out confusing labels and instructions, vague alternate text for images, and general frustration over wasted time. It advises Web designers to use clearer wording in Web site infrastructure, limit the use of plug-ins and pop-ups, and conduct user experience (UX) testing of Web pages in a linear format, the way visually disabled users experience them. Given the ubiquity of poor design, I thought, “Good luck with that!” as I read their recommendations.
UX Testing -- There is some technological challenge, owing to the wide range of conditions and disabilities, and the spectrum of users’ various stages within them. But surely the collective capability of developers, along with modern computing technology, could address poor design, lack of options, missing preferences and utilities, and other easily preventable problems. (“If we can put a man on the moon…” and all that.)
The root of the issue is not technological but economic and perhaps even cultural. There simply isn’t the public will — yet — to fix this. Much of it comes down to a lack of thorough usability testing with regard to accessibility preferences and features. This problem reminds me of ambulatory-disabled people who point out that just because an architectural element looks wheelchair-accessible — and may have even passed the Americans with Disabilities Act building code requirements — doesn’t mean that it actually is. Architects and designers often don’t bother to ask someone who gets around in a wheelchair to test their designs.
Interactive usability testing takes time and money in a development cycle, which is why most developers don’t do it at all. My brother spells out the economic conundrum: “[Product] development is labor-intensive and expensive, but it accretes value over time: the tool I develop today will be the automated basis for some tool that I develop next month. By contrast, interactive usability testers are not accumulating value in that sense.”
In addition, app developers generally consider accessibility to be a problem for operating systems and Web browsers to solve — and so it’s really Apple, Microsoft, and Google that users with impairments need to lobby.
It’s important to inventory a comprehensive list of technical inadequacies, as I’ve done here, but it’s only the first small step to increasing accessibility for all users. While it may feel gratifying to vent our frustrations about problematic computer interfaces, what low vision users really need is personalized assistance and effective solutions. In the next installment of this series, I’ll investigate what’s available in the marketplace.
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Article 4 of 5 in series
In the fourth part of our series on computing for the visually impaired, Mariva H. Aviram shares a wide variety of resources to help those with low vision use the Mac more effectively.Show full article
It’s easy to complain.
I know, because I’ve spent a lot of time complaining. First, in part one of this series (see “Computing for the Visually Impaired, Part 1,” 9 January 2015), I regaled you with the horror story of my eye troubles and resultant temporary vision problems. In part two (see “Computing for the Visually Impaired, Part 2,” 19 January 2015), I covered the myriad defects that can affect eyes and vision in general. Part three (see “Computing for the Visually Impaired, Part 3,” 26 January 2015) comprised a long list of design flaws that render even basic computer tasks unnecessarily difficult for low vision users.
Identifying the problem is the first step in fixing it. The next step is to seek and implement solutions (or to invent them if they don’t yet exist). Now I will detail the visual accessibility features, guides, and third-party apps that are available. I’ll begin with what’s already at hand, built in to your Mac.
Accessibility Display Preferences -- If you haven’t yet experimented with the Accessibility > Display pane of System Preferences in OS X 10.10 Yosemite, note that each of the following is adjustable for visual needs:
Display > Invert Colors: Enabling this inverts all the colors on screen, which can ease the reading of text for some users who prefer light text on a dark background. Bear in mind, however, that checking this box inverts all colors, including those in graphics, making them look like photo negatives. It often makes charts and diagrams much more difficult to view.
Display > Use Grayscale: Checking this box drains the screen of color, which is useful for colorblind users who have trouble discerning the subtle differences between hues with the same saturation or color values.
Display > Differentiate Without Color: Here’s another feature for colorblind users, although it seems to be a work in progress. According to the Apple Support page, checking this box makes Yosemite “use shapes, in addition to or instead of color, to convey status or information.” So far, the only thing that Differentiate Without Color changes is transforming the Away status indicators in Messages from circles to squares.
Display > Increase Contrast: Activating this achieves a few results. First, it increases the contrast of elements on the screen (such as buttons, button borders, and boxes) without changing the contrast of the screen itself. This is helpful for many types of visual impairments, including color-blindness. Second, it enables the Reduce Transparency checkbox discussed next. Third, it reverts the new flattened appearance of Yosemite’s graphical design to a more traditional look.
Display > Reduce Transparency: In Yosemite, Apple introduced what it calls “transparency” to menus and sidebars in the Finder and iTunes, so that users can (sort of) see the desktop through the menus and the sidebars. At first glance, this may look cool, but many users — and not just those with visual impairments — find that the menus and sidebars appear blurry and that the fonts of the menu text are too thin. This so-called “transparency” is actually translucency — and there’s no need for it in the context of menus or sidebars if it makes the interface harder to see.
Display > Display Contrast: This slider increases the contrast of the screen itself. You may have to experiment with the Increase Contrast checkbox and this slider in order to adjust both settings to your preferred values. (Note that sliding Display Contrast to Maximum renders the screen so bright that it may be painful for photophobic users.)
Display > Cursor Size: This slider increases the size of the pointer arrow, the cursor, and the spinning beach ball cursor. This feature is a double-edged sword: while increased cursor size is invaluable for many low vision users, the larger size obscures text and graphical elements underneath it.
Display > Open Display Preferences: This button takes you directly to the Displays Preferences, which provides options for Resolution, Brightness, and Color.
(Click the question mark icon in the lower right corner of the Accessibility window for a convenient reference.)
Accessibility Zoom Preferences -- Zoom is all about screen magnification. The Accessibility > Zoom pane offers options for controlling the zoom feature in various ways:
Zoom > Use Keyboard Shortcuts To Zoom: This setting enables the user to toggle the zoom command itself, zoom in and out, toggle smooth images, and toggle keyboard focus following, all from the keyboard. Each of these shortcuts can be assigned in the Keyboard pane of System Preferences, in Shortcuts > Accessibility > Zoom.
Zoom > Use Scroll Gesture With Modifier Keys To Zoom: With this selected, zoom in and out easily by pressing the modifier key of your choice and scrolling with a trackpad or mouse. Lots of people without visual impairments use this for quick zooming in and out on too-small elements.
Zoom > Smooth Images: Because enlarging an image may make its edges appear more jagged, this option smooths images at greater magnification levels.
Zoom > Zoom Follows The Keyboard Focus: In many apps, pressing the Tab key moves the keyboard focus among text boxes and lists; thus, when Zoom Follows The Keyboard Focus is selected, pressing Tab moves the focused text box or list into view. In other words, this automates the process of finding the location of current keyboard activity so it doesn’t get lost offscreen. Note that switching the Full Keyboard Access option at the bottom of the Keyboard > Shortcuts > Accessibility pane to All Controls provides even more targets for navigating with the keyboard while zoomed.
Zoom > Zoom Style: Select from two choices: Fullscreen, which magnifies the entire display, or Picture-in-picture, which provides a small rectangular magnifying window that can be placed anywhere on the screen.
Zoom > More Options: This button displays a new dialog for Maximum and Minimum Zoom sliders, a toggle for showing a preview rectangle, and radio button options for how the zoomed screen image moves relative to the pointer.
VoiceOver -- VoiceOver, the built-in screen reader for both Mac OS X and iOS, enables visually impaired users to read interface elements and text via spoken audio or a refreshable braille reader. It also enables full keyboard control. You can turn it on and off, and set a keyboard shortcut to toggle it, in Accessibility > VoiceOver. The real configuration takes place in the VoiceOver Utility, which can be opened from the Accessibility > VoiceOver pane, along with a VoiceOver Training app.
Limitations to Accessibility Options -- Unfortunately, there’s no way to set a system-wide type size; font sizes in each application must be set independently. While not difficult, many apps limit sizing on both ends of the scale. To change the default text size in Finder windows for Icon, List, and Cover Flow views, choose View > Show View Options > Select Text Size. Choose a font size of 10 to 16 points and click Use as Defaults to apply to all windows in the current view. Repeat for each type of Finder view other than Column view, which lacks that button. You can also experiment with font sizes in the free utility TinkerTool.
Should you be running Windows in a virtual machine, the equivalent to the OS X Accessibility preference pane is the Ease Of Access Center in the Windows Control Panel. Be warned that results when running Windows in a virtual machine may be unpredictable.
Other Relevant System Preferences -- These preference panes also provide options that may be helpful for low vision users:
General: This catch-all preference pane contains myriad interface settings, including appearance colors for buttons, menus, and windows; highlight color; sidebar icon size; and scroll bar management. Many low vision users especially appreciate the “Use dark menu bar and Dock” option.
Dictation & Speech: This set of preferences is extremely useful for enabling control and access via voice.
Dock: The Dock preferences include sliders for size and magnification, position on screen, animated effect when minimizing windows, and toggles for other Dock behavior.
Tech Guides -- To extend the Mac’s native capabilities, many third-party apps and utilities are worth considering. (And, because of Apple’s Accessibility API for developers, more of these can appear in the marketplace at any time.) High-end application suites can be pricey ($400 and up), but many simpler utilities are inexpensive or even free.
Because visual impairments are diverse, each user may have unique accessibility needs. In fact, TidBITS commenter G.F. Mueden astutely differentiated between “eye readers” and “ear readers.” “Low vision includes two groups, eye readers, those who still read with their eyes but not well, and ear readers, those who read with their ears via text-to-speech technology (screen readers). What helps one group is unlikely to help the other, and the professionals who deal with accessibility seem mostly concerned with helping ear readers — a complex affair, because screen readers are not all alike.”
It might take some experimenting to configure a setup that works best. Before investing time and money into software and electronic devices, the following resources offer a good start for research:
American Foundation for the Blind’s (AFB) Living with Vision Loss guide, including Technology Resources for People with Vision Loss. Also valuable are the AFB product database and guide to screen magnification systems.
AppleVis community of low vision users of Apple products, as well as podcasters and iOS accessibility developers
Lighthouse International’s “Make Your Computer ‘Vision-Friendly’: Practical Advice from the Lighthouse”: computer tips from low vision experts
The National Eye Institute Health Education Program’s “Living With Low Vision” booklet
LVI Low Vision International: a distributor of software and electronic products for visually impaired users
Advanced App Suites -- For those looking for a comprehensive solution, two companies have full suites of accessibility utilities for the Mac (there are many more options for Windows):
Ai Squared’s ZoomText: a suite of utilities that zooms and enhances everything on a computer screen ($399)
MagniLink iMax: a suite of utilities including magnification, contour and contrast enhancements, pointer settings, and screen reading ($495)
Screen Dimmers and Color Adjusters -- Some Mac apps offer rudimentary controls for color adjustments, such as setting white or colored text against a black or colored background. For system-wide control, though, there are a variety of screen dimmers and utilities that can adjust brightness, color, and contrast, including:
Charcoal Design’s Shades, which is free and reportedly handles multiple monitors well
ACT Productions’s Brightness Slider: This is what I use. It’s simple, effective, and free.
f.lux, a free utility that automatically adjusts the colors and contrast of your display according to the time of day for a more circadian rhythm-friendly computer experience
Zhen Liu’s Dimmer Than Dim ($2.99)
Raj Kumar Shaw’s Work at Night ($2.99)
Some visual accessibility utilities focus on making the mouse pointer easier to see and/or control:
Code Race’s myPoint Pro is an inexpensive suite ($4.99) of utilities that includes a crosshair, mouse halo, and locator for the pointer; horizontal and vertical line grid; mouse position coordinates; and an adjustable screen dimmer.
Many Tricks’s Keymo ($5) enables full control over the mouse pointer via keyboard shortcuts and can highlight the pointer position when it moves, when it’s moved by Keymo, or temporarily after a period of inactivity.
A variety of Google Chrome extensions and Mozilla Firefox add-ons provide other options for easier Web site reading. Apart from Evernote Clearly and Reasy, these mostly reformat the text.
- Evernote Clearly for Chrome and Firefox (especially helpful if you want to save to Evernote as well)
- Reasy for Chrome and Firefox (provides Rapid Serial Visual Presentation that displays the words in a single spot, so you don’t have to move your eyes)
- iReader for Chrome and Firefox
- Readability for Chrome and Safari
- EasyReader (Chrome)
- Read Mode (Chrome)
- Readable (Firefox)
- Reader (Firefox)
- Tranquility (Firefox)
Accessibility Tech Support -- For specific assistance, accessibility support staff are available at the major operating system development companies:
Apple Accessibility Support or 877-204-3930
Microsoft Disability Answer Desk or 800-936-5900
VMware Accessibility or 877-486-9273
For assistance with iOS, author and low vision expert Shelly Brisbin has recently released the iOS 8 version of her $20 ebook “iOS Access for All.”
While full accessibility for low vision users has a long way to go, improvements are often made with new releases of operating systems and utilities. Taken together, these improvements have provided more access to, and a smoother experience with, the digital world.
In the fifth and final part of this series, I will explore adaptive tech in related areas: reading tablets, audio and touch assistive devices, ergonomics, and the horizon of new innovations and future tech.
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Article 5 of 5 in series
In the fifth and final part of our series on computing for the visually impaired, Mariva H. Aviram discusses hardware options, ergonomics, and new innovations in adaptive tech.Show full article
Members of the accessibility community spend a lot of time thinking about the future — what developments are on the horizon in biotech, electronics, robotics, and computer science? This is because, while vast improvements have been made in adaptive tech, there is still a long way to go for every impaired or disabled person to experience the kind of access to the world that able-bodied people take for granted.
In the previous four parts of this series, I covered a variety of visual impairments that affect computer users, advice from eye care specialists, built-in accessibility features, and third-party accessibility apps. Now, in this final installment, I’ll explore hardware options, ergonomics, and new innovations in adaptive tech.
Electronic Devices -- Besides software, a number of electronic devices are convenient for low vision users, including text cameras and scanners, video magnifiers, text-to-speech reading machines, specialized monitors, specialized keyboards, and reading tables. For lovers of books, periodicals, and other text materials, ebook readers can be life-changing.
On E Ink in particular, ophthalmologist Dr. Benjamin B. Bert opined:
In my opinion, one of the greatest developments in recent technology is that of the Electronic Ink (E Ink) readers. These are not backlit, so they don’t have as much of the glare issues — yet they have the ability to change the font size, and some can perform text-to-speech. E Ink readers have opened up the opportunity for reading to many of those who thought they would never be able to read again.
(Competent text-to-speech apps, such as KNFB Reader, may be more convenient than carrying a separate reading device. These apps can go beyond just readers — AssistiveWare’s Wrise is a configurable word processor that allows low vision and dyslexic users to utilize multi-word prediction and to choose voice, speech rate, volume, and text formatting. Wrise is on sale for $29.99 through 22 February 2015.)
Monitors -- It occurred to me that low vision users might do better if an entire computer monitor were made out of electronic paper, maybe with a corresponding backlit flat-panel monitor or tablet that automatically displayed associated images and videos.
Optometrist Dr. Stewart F. Gooderman assured me that I was onto something, at least with the problematic nature of conventional computer monitors. He said:
The problem with backlit displays is the lack of edge and polarization. Pixels do not have sharp edges; they fade from center to edge, because they emanate light rather than reflect it. So, for those with visual challenges, backlit monitors compound blur over blur.
What I proposed is not a perfect solution, obviously — especially given the low refresh rate of E Ink. The purpose, however, of an entire computer monitor made from a non-backlit E Ink display would be mostly for gleaning text information, which is what most users need most of the time. If users needed to look at an image or a video, a separate conventional display could do that.
In fact, Dasung Tech demonstrated its PaperLike 13.3-inch E Ink monitor at CES 2015 and intends to release it on the market. Reports of the price vary wildly from $645 to $970, which may be a pain point for many low vision users.
But Dr. Gooderman didn’t like my idea of switching between displays to read text and view images: “The problem with what you want to do is that it requires two viewings, which distracts from comprehension, as well as being inconvenient. It’s like constantly having to refer to the back of the book to read the endnotes.”
As my brother has experienced, refocusing the eyes from one place to another and back is especially disruptive to visually impaired users. The Dasung PaperLike could solve this problem, but the user would have to sacrifice a high-resolution color display of images and put up with an exceedingly small screen for a modern computer.
As long as we do use backlit monitors, it’s important to use them properly. Dr. Gooderman advised, “Generally, you get more artifacts when you look at an LCD screen from the sides — superiorly or inferiorly — than when looking straight at it, so that the line of sight is perpendicular to the screen’s surface. And if you are getting numerous artifacts, it may mean you need to get a better monitor.”
When shopping for monitors, it’s important to consider your own vision needs. The market offers numerous options, each with its own advantages and disadvantages for viewing. LCD panel monitors rely on three general technologies:
Twisted Nematic (TN): Competitive gamers appreciate these affordable, widely used monitors because of their fast pixel latency response time. However, viewing angles are limited and color representation may suffer. Colorblind users may fare well with TN monitors.
Vertical Alignment (VA): The response time of VA monitors is slower than TN monitors, but VAs are brighter and reproduce colors more accurately. Black levels are relatively low, however, which can produce ghosting. Patterned Vertical Alignment monitors improve black levels, although ghosting may still occur.
In-Plane Switching (IPS): IPS is the best panel technology in terms of wide-viewing angles and consistently accurate color representation. However, contrast, black levels, and brightness are lower, and response times are comparatively slow.
Even if you’ve chosen the most appropriate monitor for your vision needs, you may still experience symptoms of Computer Vision Syndrome (CVS), such as eye strain, blurred vision, red eyes, and headaches. Computer glasses can help — sometimes immensely. TidBITS commenter Lance Diernback, for example, found that computer glasses eliminated the severe eyestrain and migraines that he experienced with computer use. If you wear corrective lenses, computer glasses can be custom-made for your specific lens prescription.
Ergonomics -- When viewing a monitor, Dr. Bert advises, “In normal circumstances, the top of the monitor should be in direct line of sight when you are looking straight ahead. That way, what you are working on is viewable from a slight downward gaze, which is most comfortable for most people.” Proper ergonomics are important for everyone, not just those with vision issues, but poor ergonomics may cause more troubles for those who are already having trouble seeing. These resources can help:
The Occupational Safety & Health Administration’s advice on proper computer workstation setup
Cornell University Human Factors and Ergonomics Research Group’s “Ergonomic Guidelines for Arranging a Computer Workstation: 10 Steps for Users”
Lighting -- Dr. Gooderman stressed the need for ambient light in order to make the entire environment more comfortable and conducive to prolonged computer work:
Lighting should be soft and indirect, without hot spots or glare. It should not be shining in your face or on the screen, nor should it be too bright. The overall lighting should be lower in intensity than in a typical office space. Add soft spot lamps on the desks to see paperwork. Bad lighting should be corrected by a knowledgeable lighting expert who may need to exchange current fixtures with new ones with the proper light source and ballasting. Ballasting in lighting also points to how the light source is spread by the use of accessories like louvers. In a pinch, install a hood over your screen.
Print Size -- Except for some unique visual impairments (such as my brother’s tiny, but clear, area in his vision for reading small, sharp text), most users find it productive to increase text size on screens (or, when available, opt for larger text in print materials).
From the article preview “Reading From Computers and Print Size” of the American Academy of Optometry’s Optometry & Vision Science (June 2014):
It is known that for the printed page, reading speed increases with print size. But is this true for reading from computers with added glare and other potentially impactful computer screen parameters? Our authors studied young (18-35 year-old) and older (55-65 year-old) participants in their study and found that indeed the same relationship exists. They went further and quantified the relationship. Each 1 mm increase in font size led to a mean productivity and accuracy improvement. Adding reflective glare on the monitor surface led subjects to move their heads forward but had no effect on productivity or accuracy. Age (with appropriate corrective lenses) had no effect on these relationships. Their study suggests productivity and posture of computer users is enhanced with larger than typical font size.
Low Vision Organizations -- For low vision users, these organizations offer assistance:
The Frank Stein and Paul S. May Center for Low Vision Rehabilitation at California Pacific Medical Center
Andrew Heiskell Braille and Talking Book Library (a division of the New York Public Library), available via phone at 212-206-5400. The Heiskell Computer Support Clinic assists low vision and blind patrons with Mac and iOS, as well as other platforms and technologies.
The Internet of Things -- Lest our exploration rest on the idea that participation in the world begins and ends solely with computers, it’s important for developers of all kinds of products to include accessibility features and adaptive tech into the devices and systems that we use in everyday life.
Chancey Fleet, assistive technology coordinator at the Andrew Heiskell Braille and Talking Book Library, elucidated:
Most users in the blind and low vision community would welcome robust accessibility features in more kinds of products. For example, it is tough to find a microwave, thermostat, or piece of fitness equipment that has spoken feedback and adjustable color, size, and contrast options. Although most of these devices have gone digital, they mostly have not yet adopted the accessibility that we value on our smartphones and computers. With a little creativity, almost any device could include accessibility, such as the simple accessible touchscreen implemented by the Lighthouse International and Creative Mobile Technologies’ partnership in pioneering taxi technology for visually impaired passengers in the United States.
And, because computers increasingly control appliances that are not specifically computer-centric, Fleet discussed the potential — and the drawbacks — of the “Internet of Things”:
The “Internet of Things” introduces new opportunities to make or break accessibility. The Nest thermostat app, for example, is accessible, meaning that a low vision or blind person can use a screen reader or magnification with it. At the same time, if an app interface is the only way to access a high-tech appliance, and that interface is inaccessible for whatever reason — the appliance may be less usable than a low-tech appliance that could be labeled simply with braille, high-contrast dots, or other modifications.
Fleet then succinctly crystallized the full-accessibility approach to product design:
It’s important to remember that not every low vision or blind person has the desire, budget, or working knowledge to use a smartphone to manage appliances. As long as controls on appliances themselves are still desirable and practical for the general public, then they should be built with universal design in mind so that users with varying abilities can engage with them as effectively as non-disabled users can.
According to Fleet, universal — that is, fully accessible — design has several notable advantages:
More users can work with a device that’s universally designed. For example, the iPhone includes features to make the screen easier to see, read content out loud, send audio to hearing aids, and allow people who find it difficult to type to dictate their reminders and text messages.
People of varying abilities can support our friends, family members, and colleagues in the use of universally designed devices. For example, if I were to advise my mother on purchasing a computer, I’d choose one with good accessibility features so that I could help her with it in the future.
Many innovations that are good for people with disabilities turn out to be popular with “typical” users. Dictation is a great example: while it supports people with fine motor impairments, such as repetitive strain injury (RSI), it’s also useful for anyone whose hands are occupied.
Future Tech -- The hope for current adaptive technology — screen enhancers and adjusters, screen readers, text-to-speech, dictation, and speech recognition — is that, as good as some of it is, it will continue to improve.
Some low vision users especially await significant advancements in audio-driven interfaces, with hardware gadgetry that could potentially resemble musical instruments. However, the future isn’t always bright: even Apple has slipped somewhat in the quality of its accessibility features (see “Apple Losing Its Accessibility Edge,” 2 February 2015).
Many technophiles are excited about the Oculus Rift virtual reality head-mounted display, although it’s not yet known how it could benefit low vision users specifically. Computerized eyewear is still so novel that those who care about eye health have reason to be skeptical. (Not to mention that these devices inadequately accommodate people who wear eyeglasses, which poses a huge obstacle to visual accessibility.)
Google Glass, for example, is potentially harmful enough to cause concern among ophthalmologists. Steve Mann, electrical and computer-engineering professor at the University of Toronto and computerized-vision system expert, detailed the ways in which devices like Google Glass cause eyestrain.
Some exciting innovations originate from individual tinkerers and social network concepts. 3D designer Michael Balzer, for example, used a 3D printer to model his wife’s cranium so that surgeons could successfully remove a tumor from her eye; in the process, Balzer pioneered a potential new standard of medical care. And then there’s Be My Eyes, a nonprofit social network that enables sighted volunteers to take requests from blind users for everyday information (navigation, product labels, etc.) via a smartphone app.
Looking Forward -- My case of viral conjunctivitis was especially fierce, and I developed an allergic reaction on top of it, which complicated and lengthened my recovery process. Despite a several-times-daily dependence on artificial tears, my eyes are back to normal, for the most part. For this, I feel an immense sense of gratitude — and, in fact, I now consider the state of my eyes as a personal touchstone whenever measuring my troubles. (“Is this more important than the health and function of my eyes? No? Well, then let’s keep it in perspective.”)
Our faculties, especially our sensory organs, are, like life itself, precious and fragile. We take them for granted until they’ve been threatened or harmed. This experience has taught me, among other things, the importance of the fundamentals of life that are easy to dismiss and squander.
Let us all take steps to protect our health and safety — and to demand both preventive precautions and accommodative measures from technology developers, institutions, and workplaces. They all need to step up to the challenge of creating safe and fully accessible environments for you, me, and everyone else — because our vision, and our participation in the world, is worth it.
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