I have tested the text-to-speech program ReadPlease , which has a free version. I just used it to read this thread (in printer-ready format) aloud to me....but it does have it's limitations. As it stands, it requires one to be able to copy & paste the desired text to it's window, and this could be tricky for a (nearly) blind user. They do promote an add-on program which integrates into Internet Explorer called Reading Bar which 'seems' to say it allows reading any web page aloud....but it is a $70 item. Needless to say, I have not tested it.

ReadPlease itself works pretty well, and could be a useful item, but I can't say how easy it would be to get used to without some help. I saw a review of the program which said that the company is working to develop advances which would make the interface easier for the blind.

There are other programs I have seen which read aloud what you type, sort of a talking text editor/spell-checker. Perhaps a combination would be helpful.

Hope this helps a bit.