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The internet is a critical resource for individuals with visual impairments (VI), including those with low vision or blindness, enabling access to information and fostering independent participation in society. However, despite advancements in screen reader software, challenges persist in navigating complex and dynamic web content. This narrative review evaluates Assistive Technologies (AT), which enhance internet navigation for VI screen reader users, focusing on design strategies and usability outcomes. A systematic search across the ACM Digital Library, IEEE Xplore, JSTOR, and ScienceDirect identified 698 studies, of which 33 met the inclusion criteria, encompassing 502 participants. Key themes were extracted from bibliographic data, technology descriptions, evaluation methods, and outcomes. The findings reveal that most software-based technologies, including browser extensions and web applications, have limited hardware integration. These solutions improve navigation by providing alternative content representations, enhancing page structure understanding, and automating user tasks. Evaluations demonstrated increased task completion rates, reduced cognitive load, and enhanced efficiency, though variations in study designs and small sample sizes limit the generalizability of results. Despite their promise, these technologies face barriers, including a lack of commercial availability and rapid obsolescence. Addressing these challenges requires modular, user-centred designs employing intuitive multimodal interactions and robust information models tailored to navigation tasks. This review emphasizes the need for scalable, sustainable, and accessible AT innovations through open, collaborative development, ensuring equitable internet access for VI users.
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