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You wouldn't need to use computer vision on a picture of the PDF. arXiv has the tex source for most of the papers. An LLM trained on code could do a pretty good job of translating tex to readable html with a bit of effort.

I'm absolutely positive a few million dollars could get you a system that can "read aloud" pdf math papers in no time. I guess people will wait for it to become cheaper though.

You can also have that cheaper already. But having it stable and reliable - will take some time and possibly more money, depending on your definition of reliable.

Mathpix is trying to achieve something like this, and they do consider the visually impaired market AFAIK, but it's pretty expensive and I have no experience with it personally, so I can't say how good it is.