Every Mac is built with assistive technologies to support people who are blind or have low vision. The VoiceOver screen reader describes exactly what’s happening on your screen. Hover Text lets you instantly magnify a selection of text. And Display Accommodations support color blindness and other vision needs.

I'm blind, and have been programming for about 13 years on Windows, Mac, Linux and DOS, in languages from C/C, Python, Java, C# and various smaller languages along the way. Though the original question was around configuring the environment, I think it's best answered by looking at how a blind person would use a computer.

Screen reader programs. People with tunnel vision from glaucoma or central blind spots from macular degeneration may find it difficult and tiring to read an entire computer screen. This is one reason that 'talking computers' were invented. Talking computers are powered by screen reader software based on optical character recognition (OCR) systems that first scan text in a word processing.
Supports MSAA, the Java Access Bridge, and PDF. Hal has been developed for blind computer users, at home, at work and in education. Hal is a software screen reader that works by reading the screen interactively and communicating through a speech synthesiser or a refreshable Braille display.
Find out about obtaining funding for an adapted computer with AbilityNet's guide: 'Funding for an adapted computer'. Blind computer users may choose to use a standard keyboard if they can learn the arrangement of the keys for touch typing but may require speech output software or a Braille display to monitor what they have typed or selected.

Hover TextGet a quick size boost of what you’re reading.

Hover Text makes it easier to view text on your display. If a paragraph, caption, or headline is too small to read, just hover over it with your cursor and press Command. You’ll get a dedicated window with a large, high-resolution version of your selection. You can even choose the fonts and colors that work best for you.

VoiceOverHear what’s happening on your screen.

VoiceOver does more than tell you what’s happening on your Mac. It helps you make things happen. It gives you auditory descriptions of each onscreen element and provides helpful hints along the way — whether you prefer using gestures, a keyboard, or a braille display. And it supports more than 35 languages, including multiple voice options.

VoiceOverIntegrated throughout macOS and every built-in app.

VoiceOver is unique because it’s not a standalone screen reader. It’s deeply integrated in macOS and all the built-in apps on Mac. And as developers update their apps to take advantage of the accessibility interfaces provided by Apple, their apps can start working with VoiceOver right away.

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VoiceOverImproved PDF, web, and messages navigation.

We’ve refined VoiceOver to make it easier to navigate PDFs, websites, and messages. In Safari, improved conformance with HTML5 accessibility standards allows for more consistent navigation of websites. VoiceOver is now better at reading aloud tagged PDFs and email messages. If you start reading a website in a different language, VoiceOver can switch to the voice for that language automatically.¹ And you can add custom commands and workflows to your MacBook Pro with Touch Bar.

Audio DescriptionsHear the details in every scene.

Watch movies with detailed audio descriptions of every scene on your Mac. Movies with audio descriptions are displayed with the AD icon in the iTunes Store.

VoiceOverNavigate VoiceOver with simple gestures.

You can control VoiceOver using many of the same gestures you use with iOS. Touch the trackpad to hear a description of the item under your finger, drag to hear items continuously, and flick to move to the next item. Enable the VoiceOver Trackpad Commander, and the trackpad surface will represent the current window or document, so you can navigate quickly to any corner or edge with a tap.

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VoiceOverA virtual controller with customizable commands.

VoiceOver features a virtual control called the rotor. Turning the rotor — by rotating two fingers on the trackpad as if you were turning an actual dial — lets you access an array of fully customizable commands. Use it to browse web pages more efficiently and intuitively. The rotor lists common elements like “headings,” “links,” and “images,” and lets you navigate directly to the element of your choosing.

VoiceOverPlug-and-play support for braille displays.

VoiceOver is the first screen reader to provide plug-and-play support for refreshable braille displays. Plug in or sync one of over 100 compatible displays, supporting more than 80 international tables, and the VoiceOver description is presented to you in braille. You can edit seamlessly in Grade 2 Braille, viewing your edits in the context of the actual line of text. Optimized for fast braille typists, VoiceOver makes working in braille easy and efficient. Converting between braille and text happens automatically so you see only Grade 2 Braille. And for sighted users who sit alongside you, there’s an onscreen braille panel that displays both braille and plain-text versions of the descriptions spoken by VoiceOver.

Dark ModeWorking hard gets easier on the eyes.

Dark Mode transforms the desktop and built-in apps with a dark color scheme that helps you focus on your work.² The fine points of your content take center screen as toolbars and menus recede into the background. Light text against darker backdrops in Mail, Safari Reader, Calendar, and more makes everything easier to read in low lighting conditions. And the Accessibility preferences for increased contrast and reduced transparency work with Dark Mode enabled.

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DictationYou say it. Mac types it.

Dictation lets you talk where you would type — and it works in over 40 languages. So you can reply to an email, search the web, or write a report using just your voice. https://newbt.amebaownd.com/posts/17187181. Navigate to any text field, activate Dictation, then say what you want to write. macOS also comes with more than 50 editing and formatting commands. So you can turn on Dictation and tell your Mac to bold a paragraph, delete a sentence, or replace a word. You can also use Automator workflows to create your own Dictation commands.

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SiriStreamline the things you do every day.

Siri helps you do more with your desktop.³ Ask Siri to send messages, track down files, create reminders, search the web, and even turn on and off VoiceOver and Invert Colors, without interrupting what you’re doing on the keyboard. And because Siri is integrated with VoiceOver, you can ask it to find a file and hear the answer read out loud. If you prefer to communicate by typing, you can easily set Siri to “Type to Siri” mode.

ZoomMake your screen up to 20 times bigger.

Zoom is a powerful built-in magnifier that lets you enlarge your screen up to 20 times, so you can better see what’s on the display. You can zoom using full screen or picture-in-picture, allowing you to see the zoomed area in a separate window while keeping the rest of the screen at its native size. A shortcut key lets you pan the screen without moving the pointer while zoomed in. macOS can also flash the screen for notifications offscreen or speak text under your pointer. The hardware acceleration engine lets you boost the size of anything on your screen — text on a web page, family photos, or a place on a map.

Zoom DisplaySee content up close and at a distance simultaneously.

Now with macOS Catalina, if you have two displays, you can keep one zoomed in close while the other stays at a standard resolution. So you