> On a related note: is mathML more accessible than an AI generated text of how a human would read the mathematical or chemical formula?

Yes, screen readers would typically allow you to navigate the formulas in ways that are more sophisticated than text (not to mention the issues with translating to Braille, which I don't claim to understand, at all). In fact alternative text is a poor substitute for structured information about the formula, which is what you get with MathML.

Plus, the MathML + screen reader combo is deterministic and debuggable, as opposed to OCR'ing an image.

> There is katex-rs[0] that outputs html and mathML. I'd assume the two could work together and the mathML would be fed to whatever the screen reader receives instead of the image?

Maybe! You are parsing the input twice, but it could be a pragmatic solution. I don't know myself how native apps are supposed to expose MathML to screen readers (or if it is even possible without an embedded browser!).