I've used Graphviz to make relationship diagrams to aid my communication with sighted people. There's an interesting Google Developer Podcast with T.V. Raman where he mentions programming directly in Postscript while he worked at Adobe. I've used LaTeX for my personal documents (CV etc.) and sighted people have asked me how on earth I managed to produce such a nice document. I wonder how feasible it would be to use Metafont for more intense graphical expressions.