@menelion @fubsepude There definately are things that can be improved and are slowly improving for example a few years ago there was an issue browsing huge lists of items that's no longer such an issue any more. The webbrowser browse navigation is improving all the time. The accessibility labels and keyboard navigation in the settings app of @gnome is much improved. Gnome calendar is keyboard accessible. The default files app has incremental search that not only searches at the begining of file names but everywhere, we have configurable keyboard shortcuts for launching our apps and scripts, Access to reading PDF files has improved, I'm not using this but I know there are sound schemes for notifying desktop events. And so on and so on. Windows software is improving too.
As for the braille I don't have a braille display but our screen reader #orca is powered by the same translation engine your screen readers #nvda and #jaws are powered on windows, that's #liblouis.
Orca has flat review, sticky focus / sticky browse mode, application specific settings, settings profiles, progress bar beeps, auto restart when it freezes or crashes, ability to display flat review content in a window, object navigation, reconfigurable keyboard shortcuts, ability to present clipboard content, reporting system information such as ram / / cpu usage, It's now getting speech screen and braille screen output usefull for #a11y testing, browse mode features outside web content to combat bad authoring to an extend, Automatic language switching for web and document content, And perhaps other usefull features I'm not thinking of right now.
It's rich ecosystem, our screen reader is very powerfull too.
The best advice I can give you for all environments is know your tools, screen reader in particular and you should be fine.