Using a screen reader or a larger interface in Layout
Set interface size from 80 to 200 percent and high contrast in Layout by Zaweba's Accessibility preferences; controls are named for screen readers.

Open Preferences > Accessibility in Layout by Zaweba to find the settings that help. There you can set the interface size anywhere from 80 to 200 percent and turn high contrast on, off or have it follow Windows. Buttons, boxes, lists and sliders have names that screen readers announce, and F6 and Shift+F6 move focus between the page, the Control bar, the tools, the panels and the document tabs.
Page layout software is dense. There are panels full of small controls, tiny icons and fine numbers, and that can make it hard going for anyone with low vision, anyone working on a high resolution screen at a distance, or anyone who relies on a screen reader. These settings are there to make the working space fit the person.
Making the interface larger
Open Preferences, which lists its sections down the left, and choose Accessibility. Set the interface size to suit you. At 100 percent you get the standard size; go up towards 200 percent for larger text, controls and panels, or down to 80 percent to fit more on a small screen.
A larger interface takes more room, so you may want fewer panels open. Panels can be collapsed, grouped as tabs or moved into a second dock column, and workspaces save and restore arrangements. Make a workspace for your larger setup so it comes back the same each time.
Switching on high contrast
High contrast can be on, off or follow Windows. Following Windows is handy if you already use a Windows contrast theme, because Layout will match it. There's also View > High contrast, which switches it quickly without opening Preferences, useful if you only need it at certain times of day or in bright rooms.
High contrast changes the interface, not your document. The colours on your pages stay as you designed them.
Using a screen reader
Buttons, boxes, lists and sliders have names that screen readers can announce, so you hear what a control does rather than just "button". Combine that with keyboard focus movement: F6 moves forward between the main areas of the window, the page, the Control bar, tools, panels and document tabs, and Shift+F6 moves backwards. Inside an area, the usual Windows keys move between controls.
Command search helps a lot here. Rather than finding a command in a menu, type part of its name and run it. The shortcuts editor lets you give often used commands key combinations that suit you, saved as a .zakeys set.
Ways to make everyday work easier
Zoom is separate from interface size. Zoom to page, spread, selection or actual size to make the document itself bigger on screen, and use the Navigator panel to keep track of where you are on a large spread.
The story editor shows a story's text in a plain view, and its display has its own section in Preferences. For long text, that can be far easier to read and edit than text set small in narrow columns on the page.
Preflight reports problems in a panel and the status bar, and takes you to each one, which is easier than hunting across pages for a missing picture.
Making documents accessible too
Accessibility in the app is one side. The other is making the documents you produce readable by everyone. Layout has alt text and decorative marking for pictures, table summaries, a Reading order panel, an Accessible preflight profile and EPUB accessibility metadata. File > Check a PDF can test a finished PDF against PDF/UA-1 rules, though it isn't a certified validator.
Set up once, these preferences make Layout by Zaweba a tool that fits the way you see and work, rather than the other way round.