Customers With Special Needs

I have a colleague who has a vision impairment. While I have seen technology to assist to overcome these obstacles (Large Monitor/TV), Text to Voice Software to read his email and word processing documents etc, they just do not seem to fit the bill.The monitor has enlarged the screen but the icons are smooth and crisp and the application is very cumbersome. I need some suggestions. I was thinking of using an HDTV monitor hoping that that would solve the visual problem and also trying to find anew text to voice package. I would LOVE to hear from anyone who has had success with these challenges!