A friend of mine did this. To provide a little more technical info on how it works: He wrote a Lua plugin for the VBA emulator which reads the emulated Game Boy

A friend of mine did this. To provide a little more technical info on how it works: He wrote a Lua plugin for the VBA emulator which reads the emulated Game Boy's RAM to find out what's on screen and the state of the game. It blew me away when I heard about it. Of course, the reason screen readers don't do this for modern software is because modern systems are just too complex. And of course, this is for just one game.