We did follow up, and there's good news and bad news. The bad news is that in light of some information we came across while researching this answer, in some respects the city appears to have taken a step backward in this area; on the other hand, we do have confirmation regarding a few restaurants that are able to accommodate you.
Something we didn't know about the first time we addressed your query -- which, quite by coincidence, was almost seven years ago to the day, back on March 14, 2006 -- was that back in 1999 an activist named Gordon DeWitty, who began losing his sight when he was five years old and was declared legally blind by the age of 10, formed an organization called Abilities 2000 to advocate for the nation's blind and visually impaired ("America's least-vocal minority," as he put it), in particular with regard to the exact same problem that you and your boyfriend encounter. Although the Americans with Disabilities Act mandates equal accessibility to goods and services for all, in practice very few restaurants cater to those with visual impairment, often leaving harried wait staff to rush through a few items, if you're lucky, just as you describe. (We can appreciate that for those fancier establishments with à la carte menus that change regularly according the seasons or the whim of the chef, the expense of having them constantly translated into other formats with such a limited shelf-life would be prohibitive, but lots of eateries maintain a pretty standard menu year-round.)
While DeWitty is (or was) a resident of Santa Fe, New Mexico, he brought his campaign to Las Vegas, and with some success: The 2009 edition of Frommer's Las Vegas with Kids describes how, thanks to DeWitty's efforts, the Monte Carlo, Excalibur, Treasure Island, Bally's, Riviera, and Harrah's were now offering braille and/or large-print menus in their coffee shops and food courts. While these are not necessarily gourmet options, at least it was a step in the right direction.
However, things move fast in Las Vegas, and not always in a positive direction. Our call around to these properties yielded a negative response from all those we were able to get through to, including TI, Monte Carlo, and the Riv. (Negotiating the centralized call center-system for Caesars Entertainment restaurant reservations these days is not an undertaking we can recommend, with endless holding patterns and a requested connection to Bally's routing us to Planet Hollywood, for example, while Food & Beverage departments everywhere seem to be continually on voicemail). We also could find no trace of DeWitty's organization, so we're not sure what the status is of Abilities 2000, or if it even exists anymore.
On the other hand, we can now confirm that the following restaurants do all carry braille and/or large-print menus:
These are the only options we've discovered to date, but it's a definite improvement on the last time around, when we drew a complete blank. (If anyone has information about other options, please drop us a line.) Whether we can take any credit for the Grand Luxe Cafe we don't know, but it's interesting that Venetian was the only resort-casino in 2006 to seem remotely interested in our inquiry, and now their coffee shop is catering to your needs, so perhaps we can chalk up another victory to the power of QoD!
Another interesting fact is that our first thought was to contact Wynn Resorts, bearing in mind Steve Wynn's own severe visual impairment, as a result of the retinitis pigmentosa (RP) from which he suffers. When he converted to veganism awhile back, every Wynn restaurant -- including the steakhouse -- was required to add vegan dishes to their menu, so we figured they might well also cater to those with reduced vision or blindness. Not so, we discovered -- not a single restaurant at Wynn/Encore carries braille or large-print menus, we were informed. Perhaps our inquiry will change that...
We'll get back to Wynn momentarily, and how it does cater to the blind, even if not gastronomically, but first we'll quickly address the second part of your question. You're correct that not only have most casinos dispensed with coin-operated machines, so you don't get to hear your winnings dropping into the tray anymore, but in addition many have dialed down the volume on their slot and video poker games. However, we called a few slot supervisors at random and were informed that Bellagio will happily crank up the volume for you, as will Silverton, where possible (it depends on the location of the speakers). Likewise Flamingo, who informed us that they'll willingly adjust the sound for you, provided the speakers are actually working, while the D downtown responded that they can and will on their new machines but that when it comes to the older ones, "not so much," as they don't necessarily have that capability. With four thumbs up, essentially, we're pretty confident that your request should be accommodated in most situations, where technically possible; simply hit the assistance button, as you suggest.
That concludes our contribution to this answer. However, in the course of corresponding with the reader who submitted this question, she revealed some very interesting "inside" information about Wynn, which we'd thought we'd share:
"There are some things in his [Steve Wynn's] casino that are probably there at least partly because of his vision, but that most people would never know, so I'll let you in on some secrets we figured out. First of all, the color red [very prominent in the Wynn color scheme, for those unfamiliar with the resort] is the first to hit the retina and for those with RP [from which this reader's boyfriend also suffers] it's the easiest to see. Secondly, the ugly casino carpets in the bright colors help [Ed: Check 'em out at the awesome Die is Cast Casino Carpet Gallery!], while the strips laid through the casino walkways at Wynn, Encore, and even Bellagio [formerly owned by Mr Wynn], surrounded by tile, are both a visual and a tactile clue for someone losing their sight. (I hope you understand what I am talking about.) [Ed: See below.]
"Also, the texture in the tiles near the gardens and such are another tactile clue. I am sure few people pay attention to the fact the butterflies in the tile are textured, but blind folks do. The same goes for the lighting: Contrast is very important to someone with RP and my boyfriend finds these casinos the easiest to navigate, now that most of his vision has gone.
"As an aside, I've seen Wynn walk near his wife, but not touching her, which is one of the ways many losing sight try to appear not to need help and to be walking independently -- as long as they brush an arm, they can still use someone as a subtle guide."
Many thanks for the fascinating insights (sorry, no bad pun intended!). We confess to being as oblivious to these details as you supposed, but we'll be sure to take a better look -- and feel -- next time we visit.
On one final note, in the course of researching this answer, we came across a story in the regional Eater blog about an enterprising teen in Louisiana who spent her summer translating local restaurant menus into Braille; perhaps someone here will be inspired to follow suit...
