Comment by RogerL

But what is the answer? What should I do differently? I get don't use images, but then what? I can't imagine all screen readers have the same capabilities, or that there is a base common ability, so what should we do?

Googling says MathML is the answer (e.g. https://www.washington.edu/doit/how-do-i-create-online-math-... this site uses MathML and your reader isn't handling it. So now what? (alt-tags? something else?)