Adobe has a PDF file reader that is not only FREE, it has accessibility features built into it for persons who are either blind or visually impaired.
The User Guide on accessing Portable Document Format (PDF) documents for persons who are either blind or visually impaired is geared towards those who use screen readers. Adobe's goal is to enable an increased understanding of issues which affect access to PDF documents through discussion of specific examples, principles, and illustration of common issues; as well as presentation of solutions. Adobe presents techniques for opening both tagged and untagged documents, as well as scanned ones, and guidance for working with PDF files that contain headings, images, tables and form controls. The guide Adobe has created is intended for entry-level users and assumes that you have already learned how to use your screen reader to accomplish tasks such as using a word processor, or browse the Internet. The guide was developed for Adobe Acrobat Reader 8.0.
Adobe's guide for persons who use screen readers and PDF files was created in collaboration with AFB Consulting, the consulting division of the American Foundation for the Blind. The guide has three sections which apply to all screen reader users.
An Introduction to the Portable Document Format
Types of PDF Files
Windows-Based Screen Reading Applications
The last section of Adobe's guide discusses ways of performing tasks using a screen reader. It also presents guidance on installation of Adobe Acrobat Reader, as well as navigation of PDF documents and use of the Adobe Reader help system.
While technology continues to advance in computer-related areas, the Adobe Corporation is making efforts to ensure that their technologies are accessible to persons with disabilities. Having used Adobe InDesign as well as Adobe Acrobat Reader, I can say from personal experience that the products this corporation produces are high-quality, reliable, and exceptionally worthwhile. The Adobe Acrobat Reader is absolutely free for anyone to use.
You can download both the Adobe Acrobat Reader and the User Guide to Accessibility Here: www.adobe.com/accessibility/products/reader/
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