5 Elements of Accessible Web Design

A common misconception is that all you need to have a successful blog or website is good content. While content people want to read is important, if you can’t see it, or it is difficult to read, very few people are going to take the time to try. There is lots of good content to choose from.

Making your content easy to scan and read and using great graphics that can tell a story are just as important. Especially if you want to reach the millions of potential readers that are blind or visually impaired.

While a person with low vision (due to age-related macular degeneration, cataracts,glaucoma or other eye diseases that are related to aging) can increase font size or graphics by enlarging them with a pinch of the fingers or scroll of the mouse, the result is often blurry and still difficult to see.

If a person is blind and using a screen reader, what they hear may not match what is written or displayed. A picture without underlying descriptive text is worthless. And when a blind person is using a screen reader to read a web site, they will often tab from link to link to scan your article, skipping over your text, to get a sense of what the options are. “Click here” says doesn’t tell the reader anything.

Here are 5 essential elements of accessible web design.

5 elements of accessible web design


Susan DeRemerSusan DeRenmer, CFRE
Vice President of Development
Discovery Eye Foundation

I See You


This is the second article from Kooshay Malek, a blind therapist in Los Angeles. Her first article, The Habit of Seeing, discussed losing her vision and her choice of becoming a marriage and family therapist. Here she discusses at how she uses her vision loss to help her patients.

When I started as a therapist, I was really concerned about my blindness. I had faced prejudice in other jobs. With my first few clients, I gave them this whole spiel at the beginning, explaining about being blind and about why I wear dark glasses.Therapy cloud - blind therapist My supervisor said not to work so hard to explain. He thought it was a nonissue: “If you were blonde and blue-eyed, would you be describing that over the phone to them?” he asked. He was right. It didn’t faze most people. In the 11 years I’ve been practicing, only a few people had a problem with it. To this day, once in a while, it may come out organically that I’m blind. Most of the time, I don’t tell them beforehand.

I think I pick up on certain nuances sighted therapists may miss. I sense shifts in energy in the room. I have very strong attunements: I notice the slightest change in tone of voice — or even in their silences — and I know something’s going on. If necessary, we talk about my blindness, and we process my blindness in the session. I don’t leave it as an elephant in the room. The main concern of everybody who comes to therapy, whether they are seeing a blind person or not, is, “Am I going to be heard and understood?” In this case, they may wonder if my blindness will affect whether I can hear and understand them. I say: “Well, we’ll have to wait and see. If there is something you think I can’t understand, would you be able to tell me?” That makes them self-sufficient in asking for help or expressing a need. Many patients tell me they find it so much easier to talk to me, because I don’t have my eye on them, so to speak, like a microscope. They find it close to the traditional psychoanalyst’s couch, where the therapist would sit behind them and not look at their face. They find out I see them better than anyone else in their life. That’s the reward of it. Especially with clients who have self-image and self-esteem issues. I get to see who is inside, not who is outside, and that’s powerful by itself. People open up more easily. My blindness is a really quiet, subtle intervention in the room at all times. It’s always present. It’s a gift I carry in there with me, and I use it.

Kooshay Malek - seeingKooshay Malek
Marriage and Family Therapist
Los Angeles, CA

The Habit of Seeing


We often take our vision for granted – and if you lose it, your life is turned upside down. I met Kooshay Malek at a Pacific Palisades Lions Club meeting and was amazed by her story. She has agreed to share with you how she “gave up seeing.” This three-part series will explore losing her vision, how it affected her career choice and how she expresses her creative nature.
kooshay malek
My eyes are what brought me to the US. I was 16 when my father and I came here from Tehran, Iran, for eye treatment. My case was an unusual case: We still, to this day, don’t have a name for it, but it’s retinal tumors of some sort. My case had been through Europe, Russia, Israel, to different conferences, and they sent me to the US as a final recourse. During that time, in 1982, it was the Iran-Iraq war, and the airports were not open. My dad and I had to get special permits to get out for medical reasons. Then to get American visas, we were stuck in Frankfurt for a couple of months waiting. It was a very challenging time. Long story short, we got to Boston, and I started receiving treatments on my left eye. It didn’t respond well, and I became totally blind on the left side. Meanwhile, I could still see 20/20 on my right side. We moved to LA, where we had friends for support, and my mother and sister joined us. I was 18 when my right eye started going bad, and I started going to UCLA/Jules Stein for treatment. I went blind in that eye when I was 22.

My father passed away two years after I lost my sight. I finished college and went through independence training at Foundation for the Junior Blind in LA. I eventually decided to go back to school to get a master’s degree in psychology, because I realized I’m a good listener and I’m always wanting to help people, so I thought it would be a good way to channel that. And as a blind person, I didn’t think I had too many career choices.

I’ve been licensed as a marriage and family therapist for the past five years. I have a part-time practice, I do volunteer work at the clinic where I did my internship, and I help train up-and-coming therapists. I think one of the reasons I was so drawn to this field is the fact that when I became totally blind while I was in college, I was able to receive free counseling through school. But once I got out, I was looking for support groups and the camaraderie I had found during independence training — being around other blind people and helping each other emotionally. I couldn’t find anything like that. The only support groups I found were for seniors, so I just found a low-fee therapist to get some support. I’d lost my dad, lost my eyes, lost my country. I was dealing with so many losses. I think that’s why I’m so passionate about doing volunteer work in this area. I tried to pull together a support group for some blind clients, but it didn’t work out, partially due to transportation and location and the same stuff blind people always run into, but I do offer low- or no-fee counseling to them. I also have good relationships with some rehab counselors who refer people to me. I think therapy is an important part of rehabilitation; you have to approach this holistically.

I’ve always been very proactive and resourceful. I’ve often thought, “If only there were a 12-step program for blind people.” I’ve always been able to relate to people in these types of programs: They have to give up a habit that’s no longer working for them, and they have to put their lives back together, step by step, day by day, one day at a time. I really related to that: I had to give up the habit of seeing.

Kooshay Malek - seeingKooshay Malek
Marriage and Family Therapist
Los Angeles, CA

The Evolving Contact Lens


Contact lenses give a person the ability to see without glasses. If you have keratoconus, they are essential for seeing as regular glasses don’t work with an irregularly shaped cornea. But lately these relatively simple lenses have created a whole new world where they can dispense eye medication, measure blood glucose levels and even help the blind see.

Courtesy Google
Courtesy Google

Monitoring Blood Sugar
You have heard about Google Glasses, but Google is looking beyond the smartphones of eye wear to monitoring health. They are currently working on a lens with tiny wireless chips and glucose sensors that are sandwiched between two lenses. They would monitor glucose levels once a second and use tiny LED lights, also inside the lenses, to flash when the levels are too high or low. And how big are these electronics? They are no larger than a speck of glitter, with a wireless antenna that is thinner than a human hair. While they are still in development – Google has run clinical research studies and is in discussions with the FDA – it could make blood sugar monitor far less invasive than pricking your finger several times a day.

Drug Delivery for Glaucoma
Getting glaucoma patients to regularly use their eye drops to regulate the pressure in their eyes has always been a problem. They forget, don’t want to be bothered, or have a hard time getting the drops into their eyes. This could change with two research projects exploring the use of contact lenses to deliver medication over a prolonged period of time.

Researchers at Massachusetts Eye and Ear/Harvard Medical School Department of Ophthalmology, Boston Children’s Hospital, and the Massachusetts Institute of Technology who are working on a lens designed with a clear central area and a drug-polymer film made with the glaucoma drug latanoprost, around the edge to control the drug release. These lenses can be made with no refractive power or the ability to correct the refractive error in nearsighted or farsighted eyes.

Another team from University of California, Los Angeles have combined glaucoma medication timolol maleate with nanodiamonds and embedded them into contact lenses. When the drugs interact with the patient’s tears, the drugs are released into the eye. While the nanodiamonds strengthen the lens, there is no difference in water content so they would be comfortable to wear and allow oxygen levels to reach the eye.

Seeing in the Dark
Researchers out of the University of Michigan have developed an infrared sensor that could eventually be used in the production of night vision contact lenses. Thanks to graphene, a tightly-packed layer of carbon atoms, scientists were able to create a super-thin sensor that can be stacked on a contact lens or integrated with a cell phone.

Stem Cells for Cornea Damage
Researchers in Australia are working on a way to treat corneal damage with stem cell infused contact lenses. Stem cells were taken from the subject’s good eye and then plated them onto contact lenses (if there is a defect in both eyes, stem cells are taken from a different part of the eye). After wearing for about two weeks the subjects reported a significant increase in sight.
Helping the Blind See
And what good are contact lenses if you are blind? At Bar Ilan University in Israel researchers are creating special lenses that translate images into sensations felt on the eye. It works by taking an image with a smartphone or camera, it is then processed and sent to the contact lens. The custom-made lens is fitted with a series of electrodes that use small electric impulses to relay shapes onto the cornea, similar to braille. After some practice, test subjects were able to identify specific objects.

In expanding the uses of contact lenses, these projects seem to be just the beginning, all reported in the first four months of this year. Researchers and developers are working together to find more and better ways help with vision and medical issues, using contact lenses.

Susan DeRemerSusan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation