Game accessibility guidelines for people with sequelae from macular chorioretinitis

Abstract Macular chorioretinitis is an ocular inflammation that may cause the permanent loss of the central vision. Researches indicate that the formation of macular scars, the potential sequela of that inflammation, is the leading cause of low vision in children. As we found no game accessibility guidelines in the literature that were specific to users with central vision loss in a preliminary review, this study thus aimed at surveying guidelines targeted at players with low vision. They were extracted through a systematic literature review conducted on digital libraries. There were some known guidelines that were not in the results of the systematic literature review and therefore we made a manual selection of other relevant sources. We also proposed a new guideline related to the sharpness of images because it was deemed important to improve game accessibility to the public concerned and it had not been presented in the literature. In total, we identified 25 general game accessibility guidelines for people with low vision, plus the one we proposed, and 20 of them were considered applicable to people with macular scars. Afterwards, based on classifications available in the literature and on the experience of the authors as developers, we assessed the feasibility of each guideline according to their impact, reach and an estimation of their implementation cost. The survey also confirmed that no guideline existed that was specific to players with central vision loss. In order to evaluate the new guideline and one of those identified in the literature from the player perspective, we developed a game prototype which implemented both. A qualitative analysis conducted with the game prototype indicated that the evaluated guidelines are applicable to the public concerned. We expect the results of this research to serve as a step towards determining how to make games more accessible to players with sequelae from macular chorioretinitis.