Why do screen readers struggle to read math?

I've been experiencing some stupid bugs and issues with InftyReader, the most concerning for me is the poor quality of recognition results of anything more complex than 1-column matrices. This sucks because i'm taking an introductory course in linear algebra. Because of copyright issues, I can only get the pdf of the course text, and not the latex source. I tried looking for pdf to latex converters but gave it up as a lost cause.

This got me to wondering: why are screen readers so bad at reading math? What are the technical challenges? The pdf I got is an actual pdf and not a series of images, so the math expressions must be in the document somewhere. What about Microsoft word equations?

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