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Click or double-click the mouse
Use VoiceOver commands to simulate mouse clicks.
Note: VO represents the VoiceOver modifier.
- Make sure the mouse pointer is on the item you want to click. - If you didn’t set the mouse pointer to follow the VoiceOver cursor (in the Navigation category of VoiceOver Utility), you must move the VoiceOver cursor to the item, then press VO-Command-F5 to place the pointer on the item. 
- To click the mouse, press VO-Shift-Space bar. To double-click the mouse, press VO-Shift-Space bar-Space bar. 
You can use Mouse Keys to control the mouse pointer (except when the NumPad Commander is enabled).