As someone who is legally blind (no functional vision in the right eye, roughly 20/200 in the left; which is rectified by simply sitting about 2-3 feet from the TV, closer than most "normal" people would find comfortable) and has mild cerebral palsy on his right side, I manage it adequately. I'm not great with precision pointing, but stuff like the Mario Galaxy games and general game/menu navigation are fine, as are remote-only games where I can just point with my left hand. My right half can manage standard controllers fine, although I can't rapid-tap or operate secondary thumbsticks very well (it's fine for minor camera work and the like, but stuff like dual stick FPS games are pretty much unplayable).
