1998 Conference Proceedings

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LOW VISION: COMBINED SCREEN-READING AND SCREEN ENLARGEMENT - A NECESSITY IN THE WORKPLACE

William F. Paul
Retired Executive Vice President and Chairman International Operations
United Technologies Corporation
Email: billpaul@compuserve.com 

and

Don Dillin
Assistive Technology Consultant
254 Milthorn Ct.
Riva, MD 21140
Email: ddillin@erols.com

Bill Paul: We believe that virtually every person with low vision who wants to remain working should be able to with the use of modern assistive technology and support of those experienced in modern low vision rehabilitation services. The problem is that those who develop low vision in later life do not have these services available and are faced with the prospect of being forced to leave the work place or revert to low paid jobs. The reason is simple: opthamologists and employers are not aware of assistive technology or believe it isn't their responsibility. Furthermore, as the person struggles with vision loss there is no one in rehabilitation they know of to turn to. The result is inevitable and only when they apply for and are qualified for disability, do they discover the services for the blind in their states including – for example -- the local Lions low vision centers.

My experiences at the outset of my discovery of Macular Degeneration in both eyes, ten years ago, was the same. Doctors told me they could do no more after laser treatments and neither they nor anyone else seemed to even remotely know about computer assistive technology and in the lesser technologies. I found that I was being prescribed the wrong glasses. I searched through magazines and catalogs with low vision products and bought what turned out to be junk which did not work.

But in the intervening ten years, I took on the task with assistive technology consultant Don Dillin to speak out, to use my "bully pulpit" as executive vice president of one of the nation's leading companies to push for solutions and to raise awareness about the unmet requirements of people with low vision. We talked with, challenged, cajoled, educated, and collaborated with people in the software industry from Optelec (LP DOS), AISquared (ZoomText), Artic Technologies (WinVision, Magnum) and Henter-Joyce (JAWS) to Microsoft and Optometrists and Opthalmologists. I believe our story is a success. Not only did I remain gainfully employed, but was promoted to Executive Vice President of United Technologies, a $24B company employing 185,000 people in virtually every country in the world.

The scope of this effort is beyond the limits of this paper, so we would like to focus on what tools are used which can help someone in the work place remain employed and what to look out for.

Let's begin with eyeglasses. Although my central vision is virtually gone, I can see peripherally and there is no reason not to use large magnifiers in both eyes provided one closes one eye at a time to read without interference from the other eye and that the distortion caused by bleeding in the eyes allows the use of magnification. I use a unique trifocal on my best eye and distance lenses, optimized for my peripheral vision in my poorer eye. My trifocal consists of a four power magnifier about one inch in diameter located on the upper part of my lens to be used as my trifocal for reading headlines and seeing pictures. Located on the bottom of my lens is my eight power bifocal which I use for reading print, particularly fine print. To fit both magnifiers on my lens, I had them both made as 3/4 moons so that when installed on my lens they look like a figure eight. The sum of this is that I can see around my 16 and 32 diopter (4 and 8 power) magnifiers. The alternatives to this approach is an adjustable binocular mounted on the lens or a high power lens mounted in a pair of glasses. These do not give one the ability to simultaneously see distance, headlines and small print.

The only way one can get this capability to my knowledge is to use an approach developed by Univision lenses in Tampa, Florida. They make high quality, high diopter lenses which can be bonded to an eyeglass. There is no mold I know of which can duplicate the approach I use.

I use overhead, moveable spotlighting (tungsten) mounted on tracks (track lighting) to provide high lumen lighting for my work surfaces and desk area. For desktops, I recommend goose neck lights with a sufficiently heavy base so that they will not fall over or collapse with heavier, advanced bulbs.

For most people, particularly those with distortion in their vision, it is imperative to use a closed circuit TV (CCTV ) to see and review written work, maps, labels on jars and prescriptions, etc. From my own experience in testing many different alternatives, a stand alone CCTV provides better resolution than those that share a computer monitor with both the computer and the CCTV. One other point is to get a high chair (or a chair with adjustable height) to view the CCTV image to prevent neck pain caused by looking up at the screen.

I use a scanner to scan multiple pages into my computer, for automatic conversion to text using optical character recognition software. Once in the computer, I can have the pages read for me, and also can enlarge the text so I can read it and make modifications. One helpful hint is to use a copier to enlarge the print of the pages to be scanned so that the characters on each page are properly separated for the character recognition system in the scanner to clearly read each character. (Note: we found that general market scanning products and OCR software were very usable for this purpose instead of purchasing specialized "blind/low vision" products. We use Caere's Omnipage version 7 for Windows 95 with a Hewlett-Packard flatbed scanner with sheet feeder. The scanning process can be started from a menu item in Microsoft Word, and the resulting text appears in the current document just a matter of seconds later for a single page.)

This brings me to the screen enlargement / screen reading system I use. I need the combination of enlargement and reading. I navigate across the computer displays with my eyes and I process words with my ears. For example, with peripheral vision I can see where I am on the screen. Since many software programs, particularly home pages and internet displays, use icons, it helps if I can see them. For example on Compuserve, if I want to go to travel, the picture of a boat is the symbol and my eyes know where it is. But when I get to the menu or am asked for selections or have to read pages of text, I use screen reading technology. To read more than a sentence is too difficult and time consuming.

Don Dillin will discuss the technical side of our search for a workable solution addressing low vision.

Don Dillin: I began working with Bill Paul in 1994 at a time when the only computer solution for someone with low vision was to use screen reader software alone, or to use screen enlargement software alone. Combinations of the two kinds of products proved incompatible at that time. (Now, nearly four years later, combining separate products still is not workable.) For reasons that Bill Paul has described, picking only screen reading or only screen enlargement was not satisfactory. While individual needs vary, many people with low vision want to see the general layout of screens or enlarged text aided by enlargement software, and then use speech output to review text or navigate menus.

Our interim solution was to pick the most workable screen reading program and the most workable screen enlargement program and turn one or the other on at a time. (For us, this combination was Artic Technologies WinVision and LP-DOS, which we later replaced with AISquared's ZoomText Plus.) This usually required completely re-starting the computer to run the other program. We attempted to get individual screen reading and screen enlargement program vendors to create a combined software, or at least to eliminate incompatibilities between their own software and that produced by other vendors. In one instance, we tried to get one vendor to reduce compatibilities within its own separate reading and enlargement programs. These efforts did not produce usable results.

Finally, by the fall of 1996, AISquared demonstrated a combined software program called ZoomText Xtra, which included both screen reading and screen enlargement elements. Today, it remains the single program on the market that combines both functions. With its roots in screen enlargement, it does a superb job of enlargement. At the same time, it can be regarded as a workable screen reader, although it does not have all of the functionality of dedicated screen reading software. While the solution is not perfect, having combined screen reading and enlargement in one program has been a large step forward for Bill Paul and others with low vision. He now uses this program on a daily basis.

For your own search, we thought it would be useful to share with you some of the considerations that guided us when we evaluated software addressing the needs of people with low vision.

  1. It should accommodate customized color combinations, usually light or white foreground letters on a dark or black background.
  2. It should track the visual focal point in mid-screen -- not screen right or screen left where the user loses the context, with speech and enlargement. This focal point includes dialog fields, application cursor, and menu items.
  3. It should "smooth" fonts to reduce "stairstep" appearance of enlarged fonts.
  4. It should track the visual focal point with concurrent speech and enlargement with good performance, so the user cannot "out-type" the screen enlarger or reader and lose track of where he or she is typing.
  5. It should allow the user to scroll or pan across the screen smoothly. (Some software was so jerky as to be unusable.)
  6. It should provide an automatic document reading feature that continuously "reads" and displays the full text of an on-screen document.

EVALUATING PRODUCTS STEP BY STEP

In our own software testing, we put each product through a series of steps that told us in very short order whether the software was workable or not. Here are a few tests that you can replicate in your own testing:

  1. Test tracking responsiveness to see if the enlargement and speech programs both keep up with your typing speed, and also see if they keep the current cursor in screen focus, preferably in the middle of the current field of view. The easiest way to do this is to type a large number of letters quickly, using the space bar every five characters or so. I do this by punching in random letters and space bar combinations, hitting about 100 words per minute or more.
  2. Test tracking on menu bars by hitting the ALT key for the application menu, and then arrowing (or cursor) right to produce the menu key words, then down arrow through the first menu selection (for example, File, New, Open, Close... etc.). Does the current menu word, or menu selection, stay in center of the screen focus? Does the screen reader speak it accurately? Does it keep up with rapid movement down a menu?
  3. Use the enlarging program's "increase enlargement" key to increase to 8 times standard size and repeat steps 1 and 2. Is there any difference in performance?
  4. Test hot key controls. Turn enlargement off, and then turn it back on again. Turn speech off and then turn it back on again. Does this work?
  5. Test for tracking and speech in dialog boxes. Go to the File Menu, and select, Save As, then TAB through the "SAVE AS ..." dialog box options. Does the current focal point in the dialog box remain center screen, or at least within the field of view where you can see some of the context for this field? Does speech give you an indication of what field you are on, and what type of field it is?

TIPS AND TRICKS WE FOUND MOST USABLE

Several tips and tricks did not require special software to improve our ability to read screens. Here are a few:

  1. COLOR AND FONT SETTINGS IN WINDOWS. Use Windows 95's Settings, Control Panel, Display, Appearance Properties settings to permanently invert the Windows 95 environment to black background and white foreground. Also change the menu fonts to 12 point or larger, bold fonts. Keep in mind that much larger than this you may lose parts of menus (they go off-screen and are invisible). Fine tuning of font sizes, and color combinations needs to be done with patience and with the aid of someone who has good vision, with you reacting to the changes, and agreeing on whether the outcomes are better than before.
  2. FONT SIZES AND COLORS ON THE WEB. Use Netscape Navigator's Options or Preferences settings to customize web page colors (such as white foreground and dark background) and fonts sizes (such as 24 point Arial Bold), overriding web page defaults. (In Microsoft Internet Explorer, the counterpart settings are View menu, Fonts.) Some resulting pages appear black on black. Try the keystroke combination CTRL + A to highlight all of the web page. This will have the effect of inverting the black on black so you can see the underlying text that was otherwise invisible.
  3. FONT SIZES AND COLORS IN MICROSOFT WORD. In Microsoft Word, use large fonts for review, then revert to small fonts for printing for distribution to fully sighted users of your information. One way to do this is to use the keystroke combination CTRL + A to highlight all of a document, then CTRL + SHIFT + P for point size, type 36 and press ENTER. This changes the font size throughout your document to 36 point (or one-half inch high). Do the same steps to revert back to 13 point. We created a macro that did these steps in one keystroke. (See the Tools, Macros menu item). Also in Word, we found that the Blue background option made documents easier to see. This is set in Tools, Options, General tab, "Blue Background, White Text" option checked.
  4. MONITOR SIZES. Consider a 17 inch screen monitor. We tested 14 inch, 17 inch, and 20 inch screens and ironically found that the 17 inch screen worked out better than the 20 inch model because it seems to be more brilliant and contrasty. This may not be universal, but it did hold true across several different manufacturers.

PRODUCT INFORMATION

Finally, we list some product sources. Different products fill different needs. The products we have used are not necessarily ideal for your own particular requirements. Test, try, talk with the vendors, make your opinions known. Some of these vendors offer trial versions of their software via their web site.

AI Squared, Manchester Center, Vermont. 802-362-3612. ZoomText Xtra. Web: www.aisquared.com

Artic Technologies, Troy, Michigan. 810-588-7370. WinVision, Magnum GT. Web: www.artictech.com

Henter-Joyce, St. Petersburg, Florida. 800-336-5658. JAWS for Windows, MAGic screen enlargement. Web: www.hj.com Optelec, Westford, MA. 1-800-828-1056. LP-DOS. Web: www.optelec.com

Syntha-Voice, Ontario, Canada. (905) 662-0565. Window Bridge and Powerama. Web: www.synthavoice.on.ca

A good web location for low vision resources is the New York Institute for Special Education at http://www.nyise.org/text/lowvision.htm

CONCLUSION

While combined screen reading and screen enlargement is essential to a growing number of low vision users in the labor force, a working combination has been elusive. A single current product that combines both enlargement and reading is an excellent start, but competitive products are needed to give end-users a greater choice in features and to encourage improvements in this type of combined product.

ABOUT THE AUTHORS

William F. Paul, now retired, was Executive Vice President of United Technologies Corporation, a $23 billion corporation that is best known for producing Pratt & Whitney aircraft engines, Otis elevators and escalators, Carrier heating and air conditioning systems, Sikorsky helicopters, Hamilton Standard aerospace systems and UT Automotive components and systems. He continues to work actively in the area of accessibility for people with low vision.

Don Dillin is a senior systems engineer and consultant in assistive technologies. For the past seven years he has provided support to clients in both government and private sectors, with an emphasis in maintaining employment for persons with visual and mobility disabilities using assistive technology.


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