Sorry fiddler, don't undertand.
No Wrong, Anahata
Was that a typo for not wrong, or do you mean I was wrong? If so, which bit?

sorry lots of visually impaired folk use screen readers
I know that. What I was asking is what the screen reader tells them.

the screen reader will tell them that it is an image
I would expect that - by spotting the <IMG> tag.

and what the image is of.
This is one bit really don't get. Do you mean the filename, or what the ALT attribute says, if present? I guess it doesn't attempt an analysis of the image content! My understading is precisely that the screen reader CAN'T tell them what the "image is of", and that's why we should use ALT attributes...

all links are also best put out in full
This is very ambiguous, and several possible interpretations add nothing to helping the visually impaired.

not just 'click here'
I never do that. I like text links to be either descriptive text or sometimes (if I think the page is likely to be printed) the actual URL or email address.

Anahata