When my best friend had an occipital stroke shortly before Christmas, one of the first things they mentioned when they got out of the hospital was how they were having trouble using their phone. They didn’t know at the time about the multitude of iPhone accessibility settings for stroke and neurological vision loss that are available on their device, and I’ve since received several messages about how much easier it is for them to type and use their device independently now that we’ve enabled these settings. Here is a list of iPhone accessibility settings for stroke and neurological vision loss that I enabled for my best friend after their occipital stroke, which highlight several ways to make iPhone easier to see. Unless otherwise noted, all of these settings are also available on iPad.
Additional background
Every individual’s experience with stroke and stroke recovery is different, and this is by no means an exhaustive list of all potential accessibility settings for stroke. My best friend had a stroke in their occipital lobe, which has affected how they access visual information, use text messaging, and also contributes to increased visual/cognitive fatigue— they specifically asked me to write a post about how I set up their iPhone for stroke recovery so that they can refer back to it later. It’s also worth noting they are comfortable with using technology, did not have any pre-existing vision loss or known risk factors prior to having a stroke, and I personally configured these settings with their input so that they didn’t have to scroll through several menus.
A lot of the accessibility settings I selected for them are also used for people with neurological visual impairment and cerebral/cortical visual impairment (CVI), which encompasses several characteristics of vision loss that go beyond visual acuity. One example of a visual behavior associated with CVI that could affect smartphone use is the impact of clutter/crowding/spacing, which can make it challenging to look at screens that have a lot of items visible at once or that appear busy or overwhelming— reducing the visual complexity and having fewer items on a screen can make a huge difference with accessing information.
Related links
- Disability Accommodations For Fluctuating Eyesight
- Learning To Explain Usable Vision
- How To Make iPad Accessible for Low Vision
- A to Z of Assistive Technology for Reading Digital Text
Hover Text/Hover Typing
In this context, Hover Text is an accessibility feature available for iPad, Mac, and Apple TV devices that enlarges content positioned under the pointer in a separate window and applies a consistent font style, color, and size to selected text. Hover Text requires users to connect a mouse/trackpad and keyboard for iPad and Mac, and is available in iOS 16 and later. While Hover Text is really helpful in some contexts, my best friend found Hover Typing to be much more useful.
Hover Typing
Hover Typing is another setting in the Hover Text accessibility menu that enlarges text that is being typed in a textbox using the same display settings as Hover Text. It does not require an external keyboard or cursor, and is automatically activated whenever a user is typing something on their device, like a text message, email, username on a login screen, or similar. Hover Typing is available in iOS 18 and above.
Display Mode
When using Hover Typing, enlarged text is displayed in a window outside of the text insertion field, similar to a screen magnifier. Display mode options for Hover Typing include:
- Docked to keyboard. Enabled by default, the Hover Typing window appears above the keyboard and was the option preferred by my best friend.
- Top of screen, centered.
- Inline— text will be displayed in the same position as the cursor.
- Bottom of screen, centered.
FONT
Text displayed in the Hover Text window can be displayed in a consistent font style, which can be selected from the Font menu and includes previews of what a font looks like. Some examples of choices that may work well for users with print disabilities include Arial, Chalkboard, Helvetica, and Verdana. My best friend preferred the bold Arial font.
SIZE
Hover Text will automatically enlarge text in a consistent size, which is the same size as the system font by default. There are 12 options for font size that can be adjusted with the slider.
COLORS
Hover Text and Hover Typing offers several options for customizing how text content is displayed within the window view, including:
- Text color
- Insertion point color
- Background color
- Border color
- Misspelled word color
- Autocorrected word color
Users can select colors from a grid, spectrum, or RGB/HEX values, as well as adjust the opacity of individual colors.
Related links
- How To Use Hover Text For iPad With Low Vision
- Learning To Type With Low Vision
- Choosing An iPad Keyboard For Low Vision
- Mainstream Technology and Low Vision: Keyboards
- Ways To Use Teleprompter Apps As Assistive Technology
DISPLAY AND TEXT SIZE
BOLD TEXT
Bold text makes all text that uses Dynamic Type thicker/heavier, which can help with identifying letters more easily for people that have trouble reading.
LARGER TEXT
To make it easier to read text without straining eyes (which can be painful or lead to fatigue), I enabled larger text sizes and moved the slider to the 8 size, which increased the size of the text on the keyboard and in all applications. If they wanted a larger or smaller font size in a specific application, this could be configured in the Control Center (more on that later).
BUTTON SHAPES
The button shapes feature puts backgrounds on buttons, so they are high contrast and therefore easier to notice. It can best be described as a subtle, shaded effect with easy to distinguish shapes. The target area is also large, meaning the buttons are easier to press.
REDUCE TRANSPARENCY/INCREASE CONTRAST
To make it easier to see applications on the Home Screen and navigate other interfaces, I turned on reduce transparency/increase contrast to increase color contrast between app foreground and background colors as well as remove transparent color effects and blurry backgrounds that can contribute to eye strain.
INVERT COLORS/Smart Invert
Invert colors (also known as inverted display or invert) is a color mode/color filter that changes a light-colored display with dark text to a dark-colored display with light text. iPhone and iPad offer two options to invert colors, known as Smart Invert and Classic Invert. Smart Invert does not invert or change the colors of pictures, images, videos, icons, or existing interfaces already in dark mode. Classic Invert will use a full color inversion, changing all display colors for content and displaying “dark mode” content in a light color palette.
Since I am frequently sending them cat pictures and don’t want to distort how these look, my best friend has Smart Invert enabled on their iPhone right now, which they have said helps them tremendously after their stroke because it provides more contrast and a less complex color palette than dark mode.
COLOR FILTER
Color filters are tools that can help reduce eye strain from screens by reducing the negative effect of blue light and/or adjusting how colors are displayed on a screen for a more comfortable viewing experience. Color filters can change how specific colors are displayed on a screen (helpful for colorblindness or color deficiencies) or apply a subtle tint to a display, similar to computer glasses or a screen protector. This can also be helpful for people who have had a stroke and want to make colors less intense, or make it easier to view screens for longer periods of time.
For my best friend, I decided to use the Color Tint setting to configure a red color at 7% intensity, which applies a subtle warm hue to the screen and acts similar to a blue light filter. I have this enabled in conjunction with Smart Invert to help with reducing bright light or super bright colors, which has been helpful for managing eye strain.
REDUCE WHITE POINT
Reducing white point lessens the intensity of bright white light, which can be helpful for reducing glare and the intensity of super bright colors. This is a super helpful accessibility setting for stroke because some people may still be sensitive to bright or intense light, or prefer a dimmer screen. My best friend has their white point set at 80% as they found this to be the most comfortable option, though other people who I have worked with personally preferred lower white point values (40%-60%).
RELATED LINKS
- High Contrast and Low Vision
- How To Use Invert Colors With Low Vision
- Five Common Technology Behaviors That Hurt My Brain
- Ten Ways To Reduce Eye Strain From Screens With Technology
MOTION
REDUCE MOTION
Motion sensitivity or feeling disoriented when using screens has been a challenge for my friend, so we decided to enable reduce motion and prefer cross-fade transitions to avoid the disorienting parallax effect to minimize the animations on their screen.
AUTO-PLAY
I turned off auto-play for animated images, message effects, and video previews to avoid surprise flashing lights or strobing content, which can be disorienting or startling if the user has no idea where it is coming from. This is especially helpful for group chats and browsing social media feeds.
DIM FLASHING LIGHTS
Bright and flashing lights can be painful to look at right now, and enabling this accessibility setting for stroke is helpful for avoiding unexpected flashing lights. With this setting enabled, video content that depicts repeated flashing or strobing lights is automatically dimmed to reduce the intensity of the lights.
Prefer non-blinking cursor
To help minimize the amount of animations on the screen, a non-blinking cursor can be enabled for typing.
RELATED LINKS
- Avoiding Flashing Lights On Social Media
- Flashing Lights and Photosensitivity in the Classroom
- How To Write Alt Text For Gifs
- How To Make Text Cursors Easier To See In Windows
SPOKEN CONTENT
For users that benefit from having text read loud but not necessarily all of the time, text-to-speech tools like Speak Selection/Spoken Content can be helpful for hearing text read out loud. My best friend preferred Speak Selection, which is activated by long-pressing on text and selecting the Speak button instead of enabling Speak Screen, which reads everything on the screen from left to right and top to bottom. Both Speak Screen and Speak Selection can be enabled simultaneously.
Highlight Content
To make it easier to follow along with text, I customized Speak Selection to highlight words and sentences (though users can select one or the other). The Sentence Highlight style is set to underline to identify what area of text is being read out loud. I also enabled word-level highlighting in Highlight Colors to aid with tracking, and my best friend selected the purple color. The default color was used for sentences.
Voices
My best friend didn’t have any interest in customizing their text-to-speech voice for Speak Selection, though there are several options for customizing the voice used as well as the rate, speed, pitch, and volume. Other people who I have worked with that have had strokes in the past preferred the Australian voices over the American options because they preferred how words were enunciated with an Australian accent.
Speaking rate
To make it easier to follow along with text as it is read out loud, select a slower speaking rate to make it easier to follow along with words as they are read out loud. My best friend preferred the 45% speaking rate.
RELATED LINKS
Touch
My best friend noticed that they kept shaking their iPhone by accident and activating settings unintentionally, but can still access their phone with a touch screen and hasn’t needed to enable voice control, switch access, or eye tracking following their stroke, though these settings can be helpful for others.
AssistiveTouch
AssistiveTouch makes it easier to access touch screen devices by creating a floating “button” that appears on the screen at all times that provides quick access to settings, shortcuts, and other device features. Users can customize the top-level menu to provide access to system tools, accessibility features, iOS shortcuts, scroll gestures, and other touch accommodations. For my best friend, their AssistiveTouch menu currently includes the following items:
- Flashlight
- Control Center
- Siri
- Background sounds
- App switcher
- Home
If they were interested, I would have considered adding another shortcut for Speak Screen so they didn’t have to use the swiping gesture, though this wasn’t something they wanted.
Shake to undo
I noticed they were shaking their iPhone unintentionally when holding it, so we turned off shake to undo to help with reducing animations and to decrease the frequency of the undo alert appearing.
Audio & Visual: Background Sounds
To help with cognitive fatigue and relaxation, my best friend has been listening to ocean sounds by finding videos on YouTube. They were excited to find out there is another option to turn their iPhone into a portable sound machine that doesn’t involve having to search for a video or requiring internet access called Background Sounds, which can be used while the device is locked or media is playing if desired.
Options for Background Sounds on iPhone and iPad include:
- Balanced noise
- Bright noise
- Dark noise
- Ocean
- Rain
- Stream
- Night
- Fire
As a side note, my best friend really disliked the “bright noise” option and was very annoyed when hearing it. I strongly recommend experimenting with different configurations as some noises may sound more unpleasant when recovering from a stroke.
Related links
PER-APP SETTINGS
Starting in iOS 15, users can customize accessibility settings for individual apps in the Per-App Settings menu, located in the Settings app. This can be accessed by opening Settings > Accessibility > Per-App Settings, which is located in the General sub-section of the Accessibility menu. These accessibility settings will be enabled automatically when the user opens the application. If no settings are configured, the accessibility settings that are currently enabled on the device will be displayed by default.
iPadOS and iOS currently offer the following options for customizing per-app accessibility settings:
- Bold Text
- Larger Text (font size)
- Button Shapes
- On/Off Labels
- Reduce Transparency
- Increase Contrast
- Differentiate Without Color
- Prefer Horizontal Text
- Smart Invert
- Reduce Motion
- Prefer Cross-Fade Transitions
- Prefer Non-Blinking Cursor
- Auto-Play Animated Images
- Auto-Play Video Previews
Per-App Settings automatically displays several applications in the App Customization menu, and users can configure settings for additional applications by selecting Add App. Alternatively, users can also configure the default settings for the Home Screen & App Library using this menu.
Related links
- How I Document Accessibility Preferences With Low Vision
- Enabling Temporary Accessibility Settings For iPad
- Customize Accessibility Settings For Specific Apps
ADDITIONAL iPhone ACCESSIBILITY SETTINGS FOR Stroke
While these aren’t configured in the Settings menu, there are several other accessibility settings available for iPhone and iPad that can make it easier to access information after a stroke or with neurological visual impairment, including:
Assistive Access
Assistive Access provides a simplified display and interface for accessing applications, which can be helpful for users recovering from stroke or that dislike visually complex interfaces. With Assistive Access, applications are displayed as a grid or list view and have a simplified interface that prioritize “core” features like sending messages or making calls without having a lot of visual complexity. Users can also add other applications to Assistive Access that are installed on the device.
To enable Assistive Access, users will need to have a PIN to turn it on/off or customize settings.
SAFARI READING VIEW
Safari Reading View is a built-in simplified reading display that is built into the Safari web browser. With a simplified reading display, text content is displayed with a consistent font size, font style, and background color, regardless of how the content is displayed on the original website. This can help to eliminate visual clutter such as ads, multi-column layouts, decorative photos, and animations, as well as provide users with the option to have text read out loud. Reading View in Safari can be launched automatically for specific websites or blog posts/articles from websites, and text can be further enlarged with pinch-to-zoom as well.
To enable Reading View in Safari, select the Reading View icon in the address bar, which looks like a lowercase and uppercase A or a series of rectangles. Long-press on the icon to customize the font size, font, and background color. Select Listen to Page to hear the content read out loud in a synthesized voice.
Reading View offers twelve font sizes, nine fonts (with a mix of sans serif and serif), and four background colors (white, sepia, dark gray, and black). Listen to Page has more limited customization options, supporting a reading rate of up to 2x speed, increased/decreased in increments of 0.25x.
Accessibility Shortcut
Accessibility Shortcut provides additional accessibility settings that can be turned on/off using either the Control Center or by triple-clicking a button shortcut (either the top button, side button, or home button depending on the device model). These accessibility settings will remain on until the user turns them off, and they will not be turned on/off automatically when opening an application.
iPadOS and iOS currently offer the following options for the Accessibility Shortcut:
- Assistive Access
- Background Sounds
- AssistiveTouch
- Classic Invert
- Color Filters
- Dim Flashing Lights
- Eye Tracking
- Full Keyboard Access
- Guided Access
- Hover Text
- Hover Typing
- Increase Contrast
- Left/Right Balance
- Live Captions
- Live Recognition
- Live Speech
- Magnifier
- Reduce Motion
- Reduce Transparency
- Reduce White Point
- Smart Invert
- Speak Screen
- Switch Control
- Vehicle Motion Controls
- Voice Control
- VoiceOver
- Zoom
If more than one accessibility feature is added, each feature will be displayed in a list when the Accessibility Shortcut is activated, so the user can choose the feature they want to access.
Control Center
Control Center provides quick access to device features and accessibility settings and can be opened within any application by swiping down from the top right corner of the device screen. Users can customize the display of Control Center by opening the Settings app and selecting the Control Center menu. From there, users can add, remove, or customize which settings they would like to display. In iOS 18, some accessibility settings are now available as options in the default Control Center menu, which has eight rounded icons at the bottom of the menu.
The default Control Center menu offers the following accessibility settings:
- Accessibility Shortcuts (listed as plural, see previous section)
- Classic Invert (iOS 18)
- Color Filters (iOS 18)
- Dark Mode
- Dim Flashing Lights (iOS 18)
- Guided Access
- Hearing
- Hover Text (iOS 18)
- Hover Typing (iOS 18)
- Increase Contrast (iOS 18)
- Live Recognition (iOS 18)
- Magnifier
- Music Recognition
- Reduce Motion (iOS 18)
- Reduce Transparency (iOS 18)
- Reduce White Point (iOS 18)
- Smart Invert (iOS 18)
- Speak Screen (iOS 18)
- Sound Recognition
- Text Size (customizable for individual apps with a slider)
- Vehicle Motion (iOS 18)
- VoiceOver (iOS 18)
- Zoom (iOS 18)
While some settings can be customized for individual applications, most settings will remain on until the user turns them off again.
Notifications
My best friend was overwhelmed by the notification badges and the constant stream of notifications on their iPhone, so we turned off as many badge notification styles as we could find and turned off notifications for several other apps as well to reduce visual clutter and overwhelm.
Related links
- Simplified Reading Displays and Low Vision
- Choosing Between Light Mode and Dark Mode For Low Vision
- iOS Magnifier and Low Vision Accessibility
More resources on iPad and iPhone accessibility settings for stroke and neurological vision loss
- Having a well-organized Home Screen can go a long way in reducing visual clutter— learn more in How To Organize Apps On iPad With Low Vision
- Another way to reduce visual clutter is to choose a wallpaper or background that is not visually complex, such as solid colors. This is also helpful if Invert Colors is enabled, since this can sometimes distort how wallpapers look.
- To make it easier to locate devices, I recommend choosing a high contrast phone case that pops against common surfaces like tables and purses, learn more in Mainstream Technology and Low Vision: Covers and Cases
- In case they have to go back to the hospital again, another helpful feature to configure is their emergency medical profile so they have quick access to a list of their medications. Learn more in How To Store Emergency Medical Information For Android and iOS
Published December 27, 2024. Updated January 2025