This isn't just a good idea for blind players - most people will be playing the game exclusively with keyboard; it seems silly to force them to use a mouse on the starting screen.

Perhaps the easiest way to simultaneously address the relative ugliness of the graphical buttons and make it better for blind players would be to replace the buttons with large clickable letters (I'm assuming that screen readers for the blind can handle large letters, though...). Obviously, a suitable font for the letters needs to be found - one that is clear enough to read, but nice enough to fit into the starting screen.

Simple toggle in the options file would make both Thomas and us blind people happy.

I thing Java Swing buttons are readable by screen readers as long as they are given a textual description, even if their representation for sighted people is graphical.

Anyway, as Aielyn says, it would be a good feature to be able to use the keyboard only. Keyboard shortcuts for each option would do the trick.

It's not that the buttons are unreadable (they do have context sensitive popups which screen readers can grab just fine), it's the mouse emulation that's a problem. Having to maneuver a free-floating cursor without guidance is a pain, to put it mildly. Self-test: Close your eyes and try to hit a specific icon on your desktop, after shaking the mouse around. You'll never know where your cursor pops up, since screen readers manipulate all kinds of virtual cursors and any one of those could become the starting point for the "actual" mouse cursor. Good luck getting it to the right button.

Navigating menus is a lesser evil, thanks to the step-by-step movement the menu bar does. Not having to bother with either thing makes life just that much easier. Memorize the shortcuts and you're done.