I know people who use XCode through accessibility on Macs, and tell me it works well. Site, some things (3d graphics) are going to be hard to ever make accessable, but what exists is fairly good, if you just standard widgets. Blind people are using Macs and iPhones, and finding them highly effective.

I suspect most Devs would never link up and keep up to date an alternative accessibility interface. Also there is a lot of benefit to the accessable and standard interface being close, to make it easy to cooperate.