Abstract
Purpose :
Moderate to severe visual impairment affects an estimated 295 million people worldwide (Bourne R, et al., 2020). It is currently unknown whether leading journals adhere to best-practices for communicating figures to the visually impaired, such as by using image alternative text (alt-text). To investigate this, we conducted a cross-sectional observational study assessing alt-text use in leading biomedical and ophthalmology journals.
Methods :
We surveyed the ten most-recently published online articles of eight leading biomedical journals and eight leading ophthalmology journals from November 2022 to January 2023 (Table 1). We examined only original research and review publications. We omitted case reports, editorials, opinion pieces, and other non-original research publications. Evaluation of journal websites was performed using the Google Chrome Web Developer extension, a plug-in tool used by web accessibility experts for evaluation of website design elements (Version 0.5.4).
Results :
Across eight leading biomedical journals, 3 (37.5%) included alt-text for their images. Of those that provided alt-text, 1 (33.3%) provided text which replicated figure title and 2 (66.7%) provided text which replicated figure position (eg, alt-text of “Figure 1” or “Figure 2”). Findings among leading ophthalmology journals were similar: 4 (50%) included alt-text and 2 (50.0%) provided text replicating figure title while 2 (50.0%) provided text replicating figure position (Table 2). No journals exhibited alt-text which provided summary or interpretation of figures. We did not observe variability in alt-text use across different publications in the same journal.
Conclusions :
Standards from the Web Content Accessibility Guidelines advise that alt-text should provide the same information as non-text content, such as figures. However, when alt-text was used by journal websites in our study, it did not convey meaningful interpretation or summary of figure findings. While captions and article text may sometimes provide overlapping information, they are generally inadequate for creating accessibility to image content. Figures are an integral component of scientific literature, yet remain widely inaccessible to visually impaired readers. Journals should improve accessibility moving forward by providing the option for authors to submit detailed and purposeful alt-text for figures accompanying a manuscript.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.