A Deep-Dive into assistive Technologies for the Blind

Today we take a deep dive into the topic of assistive devices for blind and visually impaired people. The background is that while these devices are extremely important, most people have no idea how the market actually works. Even for accessibility experts, it can be very exciting to get an insight into this area.

In general, many visually impaired and blind people require various assistive devices to manage their daily lives. It starts with very mundane things like glasses. Although a lot of people wear glasses or contact lenses nowadays, visually impaired individuals face specific challenges—such as severe vision loss that requires a correspondingly higher magnification for the lenses. This quickly puts costs into the upper three- or even four-digit range. There are also glasses with special filters that can block out specific light frequencies or enhance contrast. Novel smart glasses, whose lenses automatically tint depending on brightness for instance, will likely bring a lot of developments here. Thanks to nanotechnology, much is certainly conceivable, though these developments will be correspondingly expensive.

For blind people, a whole range of assistive devices exists. It is constantly astonishing how extensive this product range is. Anyone interested and with time to spare can visit SightCity—to my knowledge, the world's largest exhibition for assistive technologies. It takes place annually in May or early June, located relatively centrally in Frankfurt, and is open to anyone interested.

A wide variety is offered there:

  • Everyday and orientation aids: Long canes for the blind and special kitchen tools.
  • Digital tools: Paid screen readers and Braille displays that allow users to read Braille on a computer.

What is often surprising is not just the existence of these devices, but their high price tag. A Braille display used to view Braille starts at around 2,000 euros—and these are usually entry-level models with very few characters. Devices come with 12, 20, 40, 64, or 80 characters. An 80-character Braille display will set you back at least 8,000 euros.

Why are assistive devices so expensive?

  • Specialized technology: Braille displays use so-called piezoelectric modules, which are very complex to manufacture. Alternative technologies do exist—such as magnetic-based ones—that are significantly cheaper. However, these have not gained traction in Europe so far because they operate slightly louder and slower.
  • Low quantities and a niche market: An estimated 100,000 blind people live in Germany. Worldwide, the figure is significantly higher, but a large portion of those affected live in lower-income regions (such as parts of Africa, South and Southeast Asia, or Latin America). Due to a lack of financial means, these people are largely excluded from assistive devices that go beyond a simple long cane. A paradox arises: because of the high prices, the buyer pool remains small; if the products were cheaper, more people affected could afford them.
  • Lack of economies of scale: While consumer goods like smartphones roll off the assembly line in tens of millions of units and can therefore be produced more cost-effectively, the development costs for assistive devices are spread across very low production volumes. In addition, the devices are continuously being developed further, which keeps ongoing costs high.

Categories of modern assistive devices

Today, a distinction is essentially made between two types of assistive devices:

  1. Dedicated (external) devices: Products like the screen readers NVDA or JAWS as well as Braille displays are developed specifically for blind people and are generally only used by them. Sighted people simply have no need in daily life for an 8,000-euro Braille display.
  2. Integrated devices: More and more assistive technologies are directly integrated into standard operating systems. Apple, for example, offers screen readers like VoiceOver on the iPhone; the Apple Watch also features speech output, and VR/AR headsets like the Vision Pro come with built-in assistive technologies. These devices are accessible to everyone in regular retail stores.

A relatively new category is Smart Glasses. In the past, specialized assistive devices like the OrCam filled this space, but their development and distribution have since been discontinued (at the time, even the cheaper version cost over 2,000 euros and offered fewer features).

Meanwhile, modern alternatives like the Meta Ray-Ban have entered the scene. Although these glasses are sometimes discussed critically in the media, they enjoy great popularity among blind individuals. They make it possible to have surroundings described or to read text out loud—such as street signs. With a price tag of around 300 euros, this technology is significantly more affordable. In the future, other manufacturers like Google and Samsung will enter the market with similar models, bringing further dynamism to this space.

To make such assistive devices usable in the first place, drivers and often specialized software must be programmed. This represents a substantial cost factor. In this industry, we are generally talking about relatively small companies. In Germany, players include companies like HelpTech or Papenmeier. By German standards, these are small to medium-sized enterprises that cover the entire process:

  • Prototyping and product development
  • Creation of production templates
  • Software development and ensuring compatibility
  • Ongoing exchange with the blind target audience as well as manufacturers of screen readers such as JAWS and NVDA

Whether the manufacturing itself takes place entirely in Germany varies, but this enormous development and support effort is a main driver of high costs. While the assistive devices are expensive, the profit margins for manufacturers are not automatically massive as a result.

In the future, total costs are likely to rise rather than fall. Although software development may become slightly cheaper through the use of Artificial Intelligence, hardware costs have increased noticeably in recent years. Even modern technologies like 3D modeling or 3D printing, which allow for cheaper prototype production, require specialized staff with appropriate expertise.

Another massive cost driver is regulatory compliance. Many of these products are classified as medical devices in order to be included in health insurance catalog registries. Certification is an extremely complex and lengthy process. Even for established players, this represents a significant investment of time and financial resources, which ultimately must be factored into the price of the devices.

The fact that predominantly small companies operate in this industry has historical and structural reasons:

  • Founded by the target group: Many businesses were built by blind or visually impaired individuals themselves and continue to be run by them today. Accordingly, the proportion of employees with visual impairments is often high.
  • Specialized knowledge and proximity to users: Development requires deep niche knowledge of the market and the concrete daily lives of users. This demands very close, personal contact with the target audience—an effort that large corporations usually shy away from.
  • Low attractiveness for large corporations: Due to the small target group and modest margins, entering the market is hardly worthwhile for major manufacturers. While there are occasional consumer goods with voice output (such as air fryers or washing machines), specialized assistive devices remain niche products.

Although the market is small and several players have had to file for insolvency in recent years, competition still exists. A select few international players are able to drive down prices through higher production volumes.

A striking example is Vispero—a large corporate group that has grown significantly through acquisitions in recent years. Vispero's portfolio includes screen readers such as JAWS and ZoomText, as well as the former TPGi (Paciello Group) for accessibility services. Because Vispero also manufactures its own Braille displays and sells them globally (especially in the Global North), the company can achieve completely different production volumes. Additionally, its proprietary Braille displays are often bundled with JAWS.

Challenges for Start-ups and New Approaches

Due to the market size and high barriers to entry, there are very few new market entrants:

  • DOT (South Korea): A relatively new international player attempting to gain a foothold with innovative products.
  • Orbit Research: A provider trying to introduce significantly cheaper Braille displays and new form factors to the market. Orbit uses the aforementioned magnetic technology for its Braille modules, which substantially lowers manufacturing costs.

However, such alternative technologies also bring drawbacks, such as noise levels or operating speeds, which sometimes lead to acceptance issues among users. The overall market remains extremely demanding, which is why very few start-ups manage to establish themselves in the long term.

Anyone visiting SightCity will regularly discover new start-ups there—in fact, there is now a dedicated start-up corner. Many of these young companies attempt to bring novel products to market, such as orientation aids based on ultrasound, infrared, or lidar sensors. Often, however, these providers disappear from the market after just two to three years.

The reasons for the rapid demise of many start-ups in this segment are manifold:

  • Miscalculations and high prices: Development and manufacturing costs for hardware are enormously high, often rendering the products unaffordable.
  • Lack of venture capital: Hardware development requires significant capital. Without necessary venture capital, required market penetration cannot be achieved.
  • Underestimated user requirements: Ergonomics or real-world practicality in everyday life are often misjudged.
  • Lack of form factor acceptance: If solutions are too impractical or visually conspicuous in daily life, they are rejected by the target group.

A vivid example of this was an orientation aid designed to be worn over the shoulders like a heavy scarf—weighing easily a kilo and a half. While the underlying technology was potentially solid, such a solution is impractical in daily life when users are already navigating with a long cane, backpack, or handbag. Similar fates befell other curiosities, such as an orientation aid integrated into shoes, which ultimately failed to gain traction due to a lack of capital and market penetration despite several years of presence.

The Barrier of Assistive Device Numbers and Insurance Practices

A central goal for many manufacturers is inclusion in the official medical device and assistive technology catalog of statutory health insurers to enable cost coverage. However, this process is lengthy and complex.

Furthermore, cost coverage by health insurance companies has become significantly more restrictive in recent years:

  • Budget pressures: While almost every listed device was funded without question 20 to 25 years ago, insurers today face severe financial pressure. The assistive technology catalog is steadily growing, but available budgets are not.
  • Stricter necessity checks: Even traditional and undisputed devices like guide dogs or modern high-tech orientation aids are frequently met with questioning by insurers regarding whether they are strictly necessary in each individual case.
  • Rejection practices and appeals: Many health insurance providers have a reputation for issuing blanket rejections initially, hoping that applicants will not file an appeal. Securing claims often requires legal assistance.

While there are understandable individual cases where coverage is rightfully questioned—such as requesting mobility aids for bedridden individuals—in standard cases, the necessity of fundamental assistive devices for the daily lives of blind people is beyond doubt.

At the same time, a system where blind individuals simply receive whatever they wish for is not desirable either. Many of these items end up gathering dust in a corner after a few weeks, yet cannot be returned. New providers like OrCam have a interest in selling as many units as possible, regardless of whether they end up being used. This is often tied to many false promises. In my view, a leasing model or a trial period—perhaps even a paid trial—would make sense for products that are not vital life necessities.

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