PDFs are often treated as the most universal file format. They’re easy to share, they look the same on every device, and they’re commonly used for everything from reports to forms to educational materials. But PDF accessibility doesn’t always work the way people assume it does—especially when PDFs are opened with screen readers.

In a recent video by Unsightly Opinions, consultant Tamara highlighted a common problem: when PDFs are opened with a screen reader, content may be read out of order, entire sections may be skipped, or the file may be treated as completely blank even though it looks perfectly fine to a sighted reader.

So what’s going wrong?

Why PDFs Break for Screen Readers

Screen readers don’t interpret documents visually. They rely on structure—headings, tags, reading order, and semantic meaning—to understand and navigate content.

When that structure is missing or incorrect, the experience quickly falls apart.

Common issues include:

• Text read in a confusing or illogical order
• Headings that aren’t recognized as headings
• Lists flattened into paragraphs
• Images announced with no description or not announced at all
• PDFs that appear blank to the screen reader and can’t be read aloud

For blind users this isn’t a minor inconvenience—it can easily make a document completely unusable.

The Biggest Mistake: Printing to PDF

One of the most common accessibility mistakes takes place before the PDF even exists: printing to PDF instead of exporting.

When you print to PDF, you’re essentially creating a visual snapshot of the page. While it may look correct to sighted readers, much of the underlying structure that screen readers depend on is lost.

Printing to PDF often:

• Removes proper reading order
• Strips semantic tags
• Flattens headings and lists
• Creates files optimized only for sighted users

Exporting to PDF, on the other hand, preserves critical accessibility information like headings, lists, and document hierarchy.

If accessibility matters, exporting isn’t optional—it’s essential.

Simple Ways to Make PDFs More Accessible

You don’t need to be an accessibility specialist to make meaningful improvements. Small changes can dramatically improve the experience for people using screen readers.

1. Use Styles and Headings to Create a Navigable Table of Contents

Headings aren’t just for visual organization—they shape how people navigate a document.

When you apply real heading styles (H1, H2, H3, paragraph text) instead of manually bolding or resizing text, it allows screen readers to:

• Generate a usable table of contents
• Let users jump between sections
• Provide an overview of the document’s structure

Without proper headings a PDF becomes one long block of content that can only be read paragraph by paragraph.

For blind and low-vision users, headings act like landmarks. They make it possible to skip ahead, return to specific sections, and understand how information is organized.

If your PDF doesn’t create a navigable table of contents, it’s going to be significantly harder to use.

2. Add Alt Text to Images and Tables

If an image or table communicates information, it needs alt text that explains its purpose or meaning.

Purely decorative images should be marked as decorative so screen readers can skip them, but alt text for informative images ought to describe what a reader needs to know—not just what the image looks like.

Alt text shouldn’t simply name what’s visible in 60 words or less. In many cases it needs to gesture toward mood, style, or formal elements like composition, color, and texture. It may also explain how the image supports the surrounding text.

3. Avoid Strange or Decorative Characters

Repeated symbols, tildes, decorative dividers, or visual flourishes may look harmless, but screen readers often read them out loud—sometimes repeatedly.

This can interrupt the flow of content and make documents frustrating or exhausting to listen to.

If a character doesn’t add meaning, it’s best to leave it out.

4. Export Instead of Print to Create PDFs

It’s worth repeating: always export your PDFs.

A PDF export preserves structure and allows assistive technologies to interpret the document as intended. Printing to PDF often creates files that are only usable by sighted readers.

PDF Accessibility Isn’t Extra—It’s the Point

Screen readers aren’t used only by blind people.

They’re also used by people who are:

• Reviewing long documents while multitasking
  
• Reading on the go
  
• Managing eye strain or temporary visual fatigue
  
• Working in publishing, editing, or proposal review

For example, while reviewing a book proposal recently, I found that a screen reader was the fastest way to move through the document. But because the PDF had been created using the “print to PDF” method, the reader didn’t recognize any body text. It could only read the page header and stopped after each paragraph, forcing paragraph-by-paragraph navigation instead of continuous reading.

That interruption wasn’t just inconvenient—it broke the workflow.

Particularly in publishing, accessibility directly affects whether ideas can be read, evaluated, and understood. If books, proposals, and manuscripts aren’t accessible, they’re harder to review, harder to share, and harder to engage with.

PDFs are commonly used for essential information:

• Policies and procedures
  
• Forms and applications
  
• Educational materials
  
• Reports and documentation
  
• Publishing and editorial workflows

A format can’t be considered universal if it only works for some people—or only under ideal conditions.

Final Thoughts

Accessibility isn’t about perfection. It’s about making intentional choices that include more people and support more ways of reading.

If you publish PDFs you have the ability—and responsibility—to make them usable for everyone. Use real headings. Add meaningful alt text. Avoid unnecessary characters. Export instead of printing.

That’s how a so-called universal format becomes truly universal.