Alt Text and Image Description: What It Is, How to Write It, and Why It Matters to Our Retinoblastoma Community


Monday August 16, 2021


How would you access the information in an image if you can’t see it?  How would you enjoy it and feel part of the community talking about it?  Images are a key part of communication today, and making them accessible to blind and partially sighted people is vital.  Bilateral Rb Survivor. Abby White, explains what alt-text is, how to provide inclusive image description, and why this matters so much in our retinoblastoma community.

Note: Images throughout this post include examples of Facebook Automatic Alt-Text, suggested alt-text image description, and the regular image caption.


A black dog is lying on her side in her bed, a cream oval fleece covering her body. Only her head and legs are visible, so she looks like a black sheep.

Facebook AAT: May be an image of animal.

Alt-Text: A black dog is lying on her side in her bed, a cream oval fleece covering her body. Only her head and legs are visible, so she looks like a black sheep.

Caption: Annie is considering a new profession – sheepdog maybe.

What is Alt-Text and Image Description?

Images are all around us in the digital world.  From photographs, memes and emojis to graphs and diagrams, they make our virtual life and learning brighter and more enjoyable.  But an image becomes an isolating barrier for a blind or partially sighted person when it is not provided with a text description.

Imagine seeing only a blank square with the file name where the image should be.  How much less joy, knowledge, connection would you have as a result?  This is what blind people experience repeatedly every day.  The exclusion is brutal and unacceptable.  But you can help by providing simple text description of the images you share.

Images include, but are not limited to:

  • Photos of people, places, or things
  • Memes
  • Gifs
  • Screen shots
  • Logos
  • Art
  • Image text
  • Video without speech

All images on the internet have a piece of text attached to them called an Alternative Text (Alt-Text) tag.  You will see this text if the image fails to load in your browser or email client.  The default Alt-Text is provided by the hosting software (wordpress etc.) and is usually the filename or URL.  This rarely provides any useful information for someone experiencing the image through words, and is often a long string of letters and numbers that distracts from the content and amplifies the listener’s sense of exclusion.

Alt-Text tags enable the creator to attach a description of what is happening in the image, or a full transcript of text contained within it.  Distinct from the image title and caption, Alt-Text is detected by screen-reading software, which delivers the description aloud to the consumer.

Image descriptions explain the content of the graphic in words, in a way that provides a similar experience to seeing it.  A carefully chosen description completely changes the experience for someone with sight-loss.

Two children and their camp counsellor are pictured from the front in a kayak. At the back, the counsellor is wearing sunglasses and using a double ended oar, while the smiling boys have smaller, single ended paddles, all with bright yellow blades. All three are wearing orange life jackets, and the camp counsellor and child at the front are also wearing yellow Camp Sunshine t-shirts. The verdant green backdrop is reflected in the water surrounding them.

Facebook AAT: May be an image of 3 people, lake and nature. 

Alt-text: Two children and their camp counsellor are pictured from the front in a kayak. At the back, the counsellor is wearing sunglasses and using a double ended oar, while the smiling boys have smaller, single ended paddles, all with bright yellow blades. All three are wearing orange life jackets, and the camp counsellor and child at the front are also wearing yellow Camp Sunshine t-shirts. The verdant green backdrop is reflected in the water surrounding them.

Caption: An afternoon on the water during Retinoblastoma Week at Camp Sunshine.

How to Describe Images

Many people ask how they should describe images for blind people, and feel unnecessarily anxious about this step.  The best approach is to imagine you are describing the image to a friend over a traditional telephone line – you would describe exactly what you see, because you can’t send the image to your friend.

When you look at an image of your child or pet, you absorb much more information than simply a photograph of your son or dog.  Take a moment to actively think about all that you see.  Describe the surroundings as well as key points about the focus person or object.  Some details are more important than others to capture the essence of the image, to understand what it implies.

Here are several examples with both a poor description and a good one.

Bad Example: “This is a picture of my son.”

Good Example: “This is a picture of my son. Picture shows a little boy in blue jeans and a red jacket climbing on a jungle gym and grinning at the camera. There are tall trees and blue sky with some fluffy white clouds in the background.”

If an image contains a combination of text and picture, describe the picture, and include the text in full.

Bad Example: “It’s an awareness poster.”

Good Example: “Graphic shows a child holding a sign that reads: ‘Go Gold. Know the Glow. Retinoblastoma appears as a white glow in a child’s eye.’ Next to the child is a picture of an eye with the white glow of Rb.”

If the image or video contains text, that text should be provided in full either as Alt-Text or Audio Description.  If the text is too long to transcribe or include in audio commentary, it should not be presented as an image – consider alternative content to share the same message.

For more information and guidance on alternative text description for different types of images, from decorative features to charts, graphs, and maps, visit this detailed Alternative Text resource from Web AIM.

Describing Images on Social Media

Images are a huge part of social media these days – personal photos and videos, inspirational quotes, memes, screenshots, gifs, and emojis.  They make us smile or frown, laugh, and sometimes cry.  We nod knowingly in agreement, or shake our head vigorously in descent.  The information in those images brings the experience of social media, and connection with others, to life.

Imagine your social feeds without the information from those images, or with only sparse, vague auto-generated descriptors of them.  The experience can be confusing, isolating, and depressing.  You may not have access to key information, or to comforting, uplifting, or motivating messages.

Facebook continues to develop its Automatic Alternative Text (AAT) image recognition software.  Object, text, and facial recognition technology is used to generate a description, but the software’s capability to provide accurate, detailed and meaningful description is still limited.  Below are four example images, with Facebook auto-generated alternative text (AAT), and a recommended Alt-Text description noted along with the image caption.

One white woman and one black woman stand together in front of a carved sculpture of a giant glass of Guinness.

Facebook AAT: May be an image of 1 person and standing.

Alt-Text: one white woman and one black woman stand together in front of a carved sculpture of a giant glass of Guinness.

Caption: Ffion and Jayne at the Guinness Storehouse in Dublin, Ireland, during a reception at the International Society of Paediatric Oncology World Congress, 2016. Jayne had just taken a moment to help Ffion pick out some of the sculpture’s detail, which inspired Ffion to arrange a private tour for our little group.  Ffion’s face is in shadow.  When a person’s face is not completely clear in the photo, image recognition software is rarely able to define them for description.

A guide dog in harness sits in the centre of a long room. Light flows in through tall windows, illuminating the stone floor and high elaborately vaulted ceiling in honey tones. Behind Annie, a group of people are seated to the left, facing a lone woman across the room. Four stone steps at the end of the room lead up to an arched doorway.

Facebook AAT: May be an image of outdoors.

Alt-Text: A guide dog in harness sits in the centre of a long room.  Light flows in through tall windows, bathing the stone floor and high elaborately vaulted ceiling in honey tones. In the background, a group of people are seated to the left, facing a lone woman across the room, and four stone steps lead up to an arched doorway at the end of the room.

Caption: My fabulous first guide dog, Annie, on a visit to the Divinity School at Oxford University.  The door behind her leads to Convocation House. The guide dog harness confuses Facebook’s image recognition software – it is unable to define Annie as a dog.

A large cream stone is surrounded by yellow flowers, seashells and smaller stones of amethyst, lapis lazuli, turquoise, aquamarine, and silver, some sparkling in the light. Hand-written text on the large cream stone reads: “Leave footprints of love wherever you go.”

Facebook AAT: No image description available

Alt-Text: A large cream stone is surrounded by yellow flowers, seashells and smaller stones of amethyst, lapis lazuli, turquoise, aquamarine, and silver, some sparkling in the light.  Hand-written text on the large cream stone reads: “Leave footprints of love wherever you go.”

Sunburst in a blue sky with small fluffy clouds. Text reads "feed your soul."

Facebook AAT: May be an image of clouds and text. [no text description provided]

Alt-Text: Sunburst in a blue sky with small fluffy clouds. Text reads “feed your soul.”

Caption: Non-standard text is difficult for text recognition software to interpret. Always check the generated description, and write all text in full as part of your alt-text description.

Non-standard text like these two images confuses text-recognition software.  Images with poor contrast between the text and background also often confuse image recognition tools. For example, white text on a pale blue background.  Adding a drop-shadow to text when creating images can give definition that guides the software and helps people see the text more clearly.

To ensure accurate, inclusive descriptions, you can add your own descriptions to the images you upload or share on social media.  This can be done by adding Alt-Text directly to your image, or by including a text description in the post.

Attach Alt-Text to a new Image

  1. Upload your image.
  2. Scroll over the image and select Edit.
  3. Select the Alternative Text option to the left of the image.
  4. When you select Alternative Text, a panel will appear below. Above the Custom Alt-Text box, you will see Facebook’s auto-generated description, beginning: “May be an image of…”.  Your custom Alt-Text will override this.
  5. Write your custom Alt-Text, and select Save. The image attached to your post is now fully accessible to screenreaders.
  6. Use the arrow on the top left to navigate back to the post.
  7. Write your post, and send it out to your world.

Attach Alt-Text to an Existing Image

As you re-share images, or when you have time to go through your photos albums, you can add Alt-Text descriptions to make them accessible.

  1. Navigate to the image, then select the three dots in the top right corner of the post.
  2. From the drop-down menu, select Change Alt Text.
  3. The Change Alt Text panel will appear, showing Facebook’s auto-generated text above, and a text box below for your custom text.
  4. Enter your image description and select Save. Your image is now fully accessible to screenreaders.

Describing Images within Your Post

Unfortunately, most people do not take the time to make their images accessible, and it is not currently possible to add Alt-Text to images posted by someone else.  People who use some social media management tools also may not be able to add Alt-Text to their own images.  In this situation, the only option is to include a description of the image in the post, or add it as a comment.

Many blind and partially sighted people currently prefer to include all image descriptions directly in posts, including for their own images.  This is because:

  • It reminds the sighted world that this is an important thing to do, and helps to educate about the content of an image description.
  • Many people with low vision have sufficient sight to read a computer screen with included magnification settings, but their eye may struggle to interpret images. These people are less likely to have screen readers, particularly as the software is expensive.  For example, I use voiceover on my iPhone, but I do not have screenreading software on my laptop – where I do the majority of social media work and social interaction.

When adding a description in your post, clearly title the description. For example: “Image Description:…” or “Image contains:…”  If you plan to add the image description as a comment, add “Description in Comments”, and add the clearly titled description in the first comment.  Adding a description as a comment is not recommended as this takes longer to access on some devices, and breaks the flow of information.

Facebook Group Rules for Accessibility

WE C Hope has a growing Private Group on Facebook that includes many retinoblastoma survivors who are blind or have very low vision. Every survivor has the right to participate in the full group experience, to not be excluded by content.  Therefore, our Facebook Group Rules require members to include text descriptions when posting any visual content.  Moderators reserve the right to remove content that remains inaccessible to members of our community after reminders.

Alt-Text Across Social Media

Other social media platforms are developing tools to add Alt-Text to images.  Twitter, for example, has a straightforward Alt-Text feature.

  1. Upload your image.
  2. Select Add Description below the image
  3. Click OK below the brief description of why Alt-Text is important.
  4. Enter your description.
  5. Select Save. Now your image is fully accessible to screenreaders.

Look for options to add Alt-Text on your favourite social media platform.  If you are unsure, google “add Alt-Text” in combination with your chosen platform.  A little time learning and a few extra moments when sharing an image can make all the difference in the world to someone with limited or no sight.

Alt-Text for Images in Documents, Websites, eNewsletters, and Apps

Images convey a wealth of information across all kinds of media.  They can make or break the content we aim to share, and it is vital to ensure they are accessible – whether the consumer can see them or not.

Labelling action elements within websites and apps is especially important to ensure accessible navigation.  Imagine trying to navigate an app in which all trigger points are labelled “button” – you don’t know what they do or where they will take you.

Providing Alt-Text description is a basic web accessibility standard that ensures a person’s ability to navigate freely and understand content.  Failing to include it in media such as websites and eNewsletters is increasingly likely to harm visibility because the image will be treated as blank space by digital content assessment tools.  For example, websites that do not include Alt-Text will rank lower in search engines like Google, and email clients such as Gmail and Outlook are more likely to treat eNewsletters as spam when they contain images without Alt-Text.

Use Alt-Text tags to describe all images within the document, presentation, PDF, website, eNewsletter, or App you are creating.  This includes background images, bullet-point icons, photographs, diagrams and other graphics.

The process for adding Alt-Text tags varies between software, but in most instances, you can access the tool by right-click selecting “properties” within the element you wish to tag.  In some tools, particularly web-based software, the function will be immediately visible when you upload, import, or open a new image.  If you are unsure of how to add Alt-Text in your specific software, search “Alt-Text” in the help section, or google “Alt-Text” in combination with the program name and the specific version you are working with.

Inclusive Videos

Awareness of white pupil and squint as the most common early signs of retinoblastoma saves children’s life and sight.  Retinoblastoma organisations around the world have created some excellent educational videos highlighting these signs.  They also illustrate the challenges of inclusive video content, and some ways in which this media can be inclusive.

Consider the following two PSAs from Kinder Augen Krebs Stiftung (Retinoblastoma Association of Germany), and the UK Childhood Eye Cancer Trust.  Start each video, close your eyes and listen.  Don’t peak.  What do you learn from the soundtrack alone?

Text Description of KAKS Spot Video

A mother is playing with two young girls, a baby and toddler.  She invites the curly-haired toddler to take photos with her smartphone.  We see various frames of the baby smiling and the toddler having fun taking pictures, then running towards a pink fairy-lit archway to fetch her teddy bear. She runs along a hallway, dropping her bear on the way, and takes something out of a drawer.

We then see her painting her bear’s eyes white with tip-ex.  The sound of a clock begins to tick in the background. The mother watches her daughter thoughtfully, then enlarges the photo on her camera, revealing a white glow in the baby’s eye.  The screen goes black and words appear: “A white glow in the eye?” We see the child standing in the middle of the room, holding her bear, then the mother quietly watching.  A dark screen again shows the words “see a doctor”.

The End Card shows the KAKS logo of an orange square with one black and one white circle representing two eyes, and a white curve representing a smile, and the words “The Children’s Eye Cancer Foundation Germany.  www.kaks.info

Both videos tell a very similar narrative of a happy little girl whose photograph reveals a glow in her eye, but the first video has no commentary or audio description that a person with sight loss could use to understand the content.  Like many videos, this PSA is deliberately produced without commentary for visual impact, but this automatically excludes consumers with sight-loss.

This video could be made accessible by adding a text description of the content alongside it – as I have done above. This is the most straightforward way to make video content accessible to blind and partially sighted people.

In the second video, the listener does not hear a description of Rosie’s decreasing vision, her birthday celebration or her photograph showing the white eye glow.  But crucially, narration provides vital educational details the video aims to convey.

Audio description is additional narration that explains the visual information on screen. This includes action and discreet movement, facial expressions, body language, reading titles and text in full, and spelling out links and other signposts that are not phonetic.  When a person has reduced sight or none, this commentary is vital to give the video meaning and bring it to life.  The RNIB gathered these insights from people explaining what audio description means to them.

Building audio description into a video at the planning stage is significantly easier and less costly than adding it in post-production.  As the CHECT video demonstrates, audio description can be included seamlessly in regular narration for educational content.  All on-screen text and educational images can be highlighted for inclusion in the narration, spelling out any website links that are not phonetic.

Audio Description is provided as a secondary audio file that plays alongside the video, enabling the viewer to toggle the description on or off.  So advance planning is best if Audio Description is needed for videos with other spoken content.  Appropriate natural pauses between dialogue and commentary can be included, and a descriptive script can be prepared with the original content developers.

Creating Audio Description and integrating it with visual content is a highly skilled process as it must be delivered in the gaps between narration and people speaking on-screen.  The voice providing descriptive commentary must also be distinct from all other voices on the video soundtrack.  Many organizations outsource Audio Description to professional providers, while small non-profits and individuals struggle to make their content inclusive.

Closed captioning for deaf and hearing impaired consumers has become widely available online with the inclusion of captioning tools in video editor suites.  But Audio Description is rarely considered by video creators or hosting platforms.  Consequently, blind and visually impaired people feel largely excluded from this fast-expanding form of communication.

YouTube does not currently offer a tool to add Audio Description retrospectively to videos.  However, you can add Audio Description to any YouTube video – your own, or someone else’s – thanks to YouDescribe.  Developed by the Smith-Kettlewell Video Description Research and Development Center, this clever tool is enables anyone, anywhere in the world, to make a video accessible.  Anyone can edit and add to an already-described video to help make the description more accurate and the content more engaging.

Adding Audio Description radically changes the accessibility of a video.  Consider the two versions of the following video, which was created by the International Olympic Committee, and made accessible by a YouDescribe global citizen,

Add Audio Description with YouDescribe

To add Audio Description using YouDescribe, you will need to create an account and be logged in.

  1. Copy and paste your selected YouTube URL into the YouDescribe search box and click Search.
  2. The YouTube video will appear as either DESCRIBED or NON-DESCRIBED. You can click through to an existing video and Add Description or select Describe under the new video.
  3. Use the ‘Play/Pause function on the video player to pause when you wish to add audio description.
  4. Use the Record function to record your audio description, then select Upload to add that new audio file.
  5. Repeat steps 3 and 4 for each segment of audio description until you have completed the video.
  6. When the process is complete, your completed video should appear on the YouDescribe home page, at the top of the NEW VIDEOS list. The video can now be played with audio description, and you can share its URL so others can fully engage with it.

Sadly, once the audio file is created, the video can only be viewed with Audio Description via the YouDescribe website – it is not an integrated option like closed captioning.  Like most mainstream video hosting websites and players, YouTube cannot play more than one audio track simultaneously, and therefore cannot support audio description tracks.

Host Your Own Audio Described Videos

You can however host your own YouTube videos (and content from other platforms) with Audio Description using the free 3Play plugin.  The embed tool references the selected video and plays the Audio Description track alongside the video’s audio track. Audio Description can be toggled on or off in the video player, eliminating the need to create a separate audio described video.  The plugin includes a range of other accessibility tools, including closed captioning, keyword search and PDF download of the transcription.

A pretty cream cat with a black tail and a few black markings, including a teardrop marking over her nose, is sitting on a stepping post of her climbing unit, leaning down towards Bagpuss, an old pink and cream striped cloth cat, who appears to be looking up towards her.

Facebook AAT: May be an image of cat. 

Alt-Text: A pretty cream cat with a black tail and a few black markings, including a teardrop marking over her nose, is sitting on a stepping post of her climbing unit, leaning down towards Bagpuss, an old pink and cream striped cloth cat, who appears to be looking up towards her.

Caption: One wise and saggy old bagpuss sharing advice with another.  My beautiful Tosca.

 

Building an Inclusive Community

Adding image description is something few people think about when posting on social media or creating documents and presentations.  Even when we work and live with blind and visually impaired people, or have visual impairment ourselves, this step may not come naturally.

I often need this additional information myself due to limited sight, and my blind father needed this information all the time.  I feel aggravated and left out when people don’t add image description – but I forget to add description sometimes too, and I don’t know all the ways to create accessible content in every medium.

I am frustrated, saddened, and sometimes very stressed by the conflict that arises from lack of image description on social media.  As a Facebook Group administrator, I am increasingly caught in the cross-fire between individuals who need image description to understand and engage with content, and posters who feel vilified for not providing the description.  I see friends on both sides leaving valuable communities because they feel demoralized and abused.

It would seem obvious that our retinoblastoma community includes members who are completely blind, or have severely limited sight, for whom image description is vital. Yet even within our small, rare community, there is a wide range of experience and awareness.

A parent or a survivor with good vision in one or both eyes may have never before had the opportunity to connect with other survivors, or learn much about the cancer beyond their own experience.  They may have never spent time with someone who is blind, to learn about their experience and needs.

Most images posted on social media by individuals are spontaneous uploads. The person is moved to share an experience with their community.  They aren’t thinking of how other people will receive it; they are simply feeling the emotion of that moment, and responding to it.  They likely have distractions swirling around them – demanding children, conversations mid-flow, half-completed tasks, the television program they are following…  Perhaps they will suddenly think of the forgotten image description while lying in bed hours later – this has been my experience on several occasions!

On the other hand, people who are totally blind or have very limited sight need image description to engage with visual content.  Not having this information is absolute exclusion.  Being presented with an inaccessible image feels like being physically shoved into the corner while everyone else gathers together to discuss something they don’t want you to be part of – like being told “you are not wanted here, go away”.

People with sight loss have to fight all the time to be included in a world designed for the sighted.  We experience hundreds of exclusionary micro-aggressions every day.  Retinoblastoma survivors should not have to fight to feel at home in our own community, yet members ask over and over again for image description.  When frustration, pain, and anger boils over, the individual post without image description may be the trigger, but it is the cumulative toll of exclusion over many years being expressed.

Sadly, the pained reaction to the triggering post that lacks image description may itself become a trigger for a parent or survivor who is looking for support at a critical time in their cancer journey.

Many in our community are daily impacted by medical diagnoses, emotional scars, and ongoing challenges that reduce our tolerance threshold and ability to be present for one another.  Understanding, respect, patience and self-regulation is needed on both sides. Moderation and leadership is important, but ensuring our community is a safe, welcoming, and inclusive space for all members is a shared responsibility.

We can all help grow a more inclusive culture together with simple friendly request for description and explanation of the need.  Most people are reasonable, want to help and be kind to one another.  It is easier to do that when you are being asked politely and you understand what you are being asked and why.  People who feel accused or abused are more likely to become defensive, uncooperative, and also feel unwelcome, which helps no one.

While social media is virtual, it is not necessarily an instant communication tool. If you ask someone to add a description and they don’t respond, their silence does not mean they don’t care.  They may be unavailable, and they may not check social media regularly.  Please be patient.

If you see a request to someone for image description has gone unanswered, you can quickly jump in with a description to help.  Just as you would step in to assist someone in a real world situation who asks for assistance, this is an opportunity to be a good citizen, and your help will be much appreciated.

We are stronger together, gently learning from one another, helping one another out, and building one another up!

Part of a large sanctuary, spanning four tall columns. Five large windows are recessed within arches beautifully carved and decorated with colourful tile mosaics. The arched windows are fully decorated with panels of stained glass in geometric patterns, and the upper portion of the central window is less saturated than the four windows to the left and right. Sunlight streams in, splashing a bright rainbow of colour across the empty floor and intricately woven carpet. The overall effect is a dazzling kaleidoscope of light.

Facebook AAT: No photo description available. .

Alt-Text: Part of a large sanctuary, spanning four tall columns. Five large windows are recessed within arches beautifully carved and decorated with colourful tile mosaics.  The arched windows are fully decorated with panels of stained glass in geometric patterns, and the upper portion of the central window is less saturated than the four windows to the left and right. Sunlight streams in, splashing a bright rainbow of colour across the empty floor and intricately woven carpet. The overall effect is a dazzling kaleidoscope of light.

Caption: Nasir Al-Mulk Mosque in Shiraz, Iran.

About the Author

Abby’s father was diagnosed with bilateral retinoblastoma in Kenya in 1946. Abby was also born with cancer in both eyes. She has an artificial eye and limited vision in her left eye that is now failing due to late effects of radiotherapy in infancy.

Abby studied geography at university, with emphasis on development in sub-Saharan Africa. She co-founded WE C Hope with Brenda Gallie, responding to the needs of one child and the desire to help many in developing countries.  After receiving many requests for help from American families and adult survivors, she co-founded the US chapter to bring hope and encourage action across the country.

Abby enjoys listening to audio books, creative writing, open water swimming and long country walks.

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