The following Accessibility options are supported in Back 4 Blood:
- Text to Speech - On and Off
- Text to Speech Voice - Male/Female
- Text Language
- Speech to Text
- Profanity Filter
- Caption Options (full, gameplay only, conversations only)
- Caption Font Size
- Background Opacity on subtitles
- Different Color Gameplay Captions (protanopia, deuteranopia, tritanopia
- Camera Motion Strength
- Waypoint Opacity
- Screen Space - change how close the in-game HUD is to the edge of the screen
- Cross-play enable or disable
- Voice Chat Matchmaking Preference (yes or no)
- Reset Game Coach
- Remappable Keys on Controller and KBM
- Reticle Options
- Reticle Color (7 colors)
- Lower Game Audio for Voice Chat Toggle
- BG Audio is lowered during dialogue
- FOV Adjustment
- Toggle all weapons to be full auto.
- Text to Speech for tooltips in the Options Menus.
- Text to Speech for Muxy Game Link options.
- Copper and Mutation Point text color change based on colorblind settings.
- Cleaner retching sound effects now have their own option in the Options menu, and can be turned off at any time.
- Enable or disable Cleaner stamina breaths
- Text Descriptors for options
- Custom Colorblind Options - can manually change the color of various screen elements instead of sticking to the three options provided
- Enable or disable Motion Blur. Can also disable motion blur caused by the camera but retain object motion blur
- Ability to disable Blood Drench
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