Eye (2021) 35:2078–2080

https://doi.org/10.1038/s41433-021-01499-w

COMMENT

Smartphones as assistive technology for visual impairment

1
Suraj Singh Senjam

Received: 22 February 2021 / Revised: 25 February 2021 / Accepted: 25 February 2021 / Published online: 17 March 2021
© The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2021

In general, smartphones are often not viewed as assistive
technology for visual impairment, especially in low-middle-
income countries. This is because operating a smartphone
heavily relies on good visual function and is, therefore, not
particularly accessible to a person with a visual disability
[1]. There is a perceived limitation among the public,
healthcare providers and vision rehabilitation professionals
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feature is tremendously useful to perform activities of daily
living, communication and social interaction for visually
impaired or blind users, where human-vision-smartphone
interaction is impossible or poses a great challenge. Others
features, such as Zoom Magnification, Invert Colours,
Large Text, etc., are accessible built-in smartphone features
commonly used by people with visual impairment (Fig. 1).

on the use of smartphones by individuals with visual In addition, there are many third-party accessible
impairment. Major reasons for this could be due to a lack of smartphone applications that also make eyes-free interaction
awareness and less understanding of the beneficial aspects with the visually disabled possible (Fig. 2). These accessible
of the various accessible features and accessible applica-
tions of current smartphones, resulting in poor recommen-
dation to vision rehabilitation services.
Over the years, research on “Human-Computer-Interac-
tion” has been gaining a lot of attention across the world
[2]. Smartphones are one of the greatest digital technolo-
gical advances of the twenty-first century and contain many
of the special features and functionalities of computer
technology, including those relating to electronic informa-
tion and communication systems. Various innovations on
the use of other body senses, for example, gestures, haptic,
and audio, other than vision have been developed, making
possible truly eyes-free means in human-smartphone inter-
action and leading to a significant improvement in acces-
sibility to individuals with visual impairment [3].
A large number of accessible built-in features have been
developed specifically for people with blindness and visual
impairment, which can be operated on iOS, an Apple
operating platform, or Android-based smartphones [4]. For
example, the most widely used built-in accessible feature is
TalkBack for Android operating system or Voice Over for
Apple operating system (iOS) as a screen reader. This

* Suraj Singh Senjam

drsurajaiims@gmail.com
Fig. 1 Invert Colors app in a smartphone (A low vision client, with
1
Department of Community Ophthalmology, Dr. Rajendra Prasad a smartphone attached to a gooseneck mobile stand holder,
Centre for Ophthalmic Sciences, All India Institute of Medical reads a print on a reading stand). A smartphone using the Invert
Sciences, New Delhi, India Colours app.
Smartphones as assistive technology for visual impairment
Fig. 2 A smartphone in use with Eyes-Free Interaction (A com-
plete blind student touches his finger on smartphone’s screen to
identify the contents or icons underneath his finger with voices
from the device). A smartphone in use with eyes-free interaction.
applications are based on audio, tactile or haptic-based
interaction and substitute the need for visual-based inter-
action with the smartphone. The majority of these acces-
sible applications are freely available online and can be
downloaded for a specific purpose. These accessible apps
can be used for object and obstacle identification, sighted
help using a specific app, communications, emailing,
reading e-Books, writing (Kibo, Access Note, KNFB
Reader, TalkBack, Be My Eyes, Braille Touch, Visor, etc.),
news reading and listening (AccessWorld, Blind Bargains,
etc.), entertainment, calendar functions, currency identifi-
cation (Mani apps), GPS navigation (BlindSquare, Seeing
Eye GPS, etc.) social networking, recording memos, colour
identification, talking calculator, and so on.
These accessibility features and applications enable
smartphones to serve as assistive technology for the blind or
visually impaired, thereby, facilitating independent living,
daily activity performance, engaging in education, societal
activities, accessing information and finally, support in
enhancing the overall quality of life.
An exploratory study on smartphone use among people
with visual impairment shows that more than 90% of
respondents used their smartphones for activities such as
calls, sending and receiving messages, browsing the web
2079
and reading emails; 70–80% used smartphones for calendar
functions, listening to music, social media and networking;
60–70% for reminders and to take photos for reading with
optical character recognition technology [5].
In a global survey on the use of smartphone accessible
apps, more than 95% of people with visual impairment
reported that these special accessible apps are useful, and
are being used to accomplish their daily routine activities
[6]. This study also reported that smartphone apps can
function for multiple tasks that facilitate their independent
living. Another study also showed among people with
visual impairment that participating in digital arenas and
accessing digital technology, including smartphones,
reduced the feeling of loneliness, improved social contact
and participation, helped in information sharing and gaining
better interaction with friends and family [7].
The main advantage of using mainstream devices, such
as smartphones, is that the user is less likely to accentuate
being visually impaired in public compared to the use of
traditional devices, such as magnifiers and Braille, etc.
Furthermore, they are less likely to pose a social stigma,
cause less discomfort on use, and seldom have a negative
reaction from peers to the users. In addition, smartphones
are visually and physically demanding, being designed
universally, user-friendly and are ubiquitous with a much
lower price these days. Furthermore, easy portability with a
lanyard or holsters at any place and at any time is an aes-
thetic feature of smartphones. Therefore, the abandonment
and disuse of a smartphone is likely to be lower when
compared to traditional assistive devices.
The number of accessible apps and accessible features is
growing over time for people with visual impairment.
Designers are continuously fostering to develop more
innovative and accessible apps for visual impairment and
blindness. These may lead to complexity in use of apps
among the users, since the majority of the apps have a
specific function, though some functions are overlapped.
There is not a single app that fits all purposes. The need of
each individual usually is specific, so accordingly initial
assessment of the requirement will be helpful and followed
by tailoring the smartphone training programme to meet the
specific needs. All in all, the advance in smartphone tech-
nology has provided a new platform and opportunities for
people living with visual impairment to reduce many of the
barriers and challenges encountered in their everyday lives.
There is an overarching need to develop clinical or users’
guidelines on the use of the accessible apps and features of
smartphones that will potentially assist in appropriate
recommendations for various types of individual’s activities
and vision loss. Further, digital literacy and providing
training on the use of smartphones in people with visual
impairment should be in line with the development priority
for digital technology.
2080
Compliance with ethical standards
Conflict of interest The author declares no competing interests.
Publisher’s note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.
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