I'm pretty sure that you can get your hand up to that socket through the ashtray opening. It might depend on whether you are AC or not. If done through the ashtray opening, you are limited to using one hand - it's tough, but worth a try.
The lamp base releases from the back of the HVAC panel with a CCW twist. The 194 bulb is just pushed into the base. Grab the bulb with your thumb and index finger then yank it straight out of the slots in the base. You can feel okay about pulling against the wiring - it's a double lead connection and sturdy. Pull your hand out of the ashtray opening and load up a new bulb.
This is the tricky part, trying to press the new bulb into the socket with one hand - and doing that while not being able to see what you're doing. If you get the bulb to seat properly (test with dimmer to confirm), insert the socket into the back of the panel and twist CW to lock.
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