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Because people in the United States are highly reliant on cars for transportation, individuals with restricted driving abilities face severe accessibility constraints in the labour market. Guided by the social exclusion framework, we used a qualitative approach to gain insights into the role of car driving and alternative commute modes in the lives of white-collar workers with degenerative eye conditions. The study participants gradually restricted their driving behaviour as the disease progressed. They also exhibited several types of commute solutions, which lent themselves to a variation in the experienced degree of exclusion (both between participants and within participants over time), with changes in vision state and available resources. Another aim of our study was to identify the motivations for driving behaviour. The results showed that while a desire to reduce the risk of an accident motivated the participants to stop driving, certain normative (for men) and practical considerations motivated participants to continue driving. While all of the participants eventually stopped driving due to vision decline, the decision to quit often occurred only after the participants experienced one or more car accidents. Workplace accessibility is a factor that hinders labour market participation of individuals with degenerative eye conditions and encourages individuals to engage in risky behaviour. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to describe the interplay between the work trajectories and the passing patterns of individuals with degenerative eye conditions in different phases of their career, as well as the disease progression and the career and well-being outcomes associated with different works and passing trajectories.Methods: Qualitative interviews on the topic of work trajectories were conducted with 36 working or retired individuals with degenerative eye conditions. The “bigger picture” method was used to explore passing and concealment behavioral patterns, and their associations with various work trajectories.Results: Five patterns of passing and concealment behavior in the workplace were identified and were linked with various work trajectories among visually impaired study participants: (1) no career adjustments, concealed condition throughout career; (2) revealed condition after adjusting career plans; (3) increasingly open about their condition over the course of their career; (4) engaged in career planning, always open about their condition; and (5) engaged in limited career planning, always open about their condition.Conclusions: Patterns characterized by less planning and more identity concealment were associated with more stress and lower levels of self-acceptance, while patterns characterized by more planning for vision deterioration and less passing behavior were associated with higher levels self-acceptance and fewer obstacles over the course of an individual’s career. The study’s findings can serve as a guide for health professionals.Implications for RehabilitationMany individuals with degenerative eye conditions try to conceal their identity as visually impaired in the professional setting.Different aspects of career outcomes (e.g. age of retirement) and wellbeing outcomes (e.g. self-acceptance and stress) associate with identity concealment patterns of individuals throughout their careers.Identifying concealment patterns will allow health professionals to tackle particular adverse outcomes and challenges associated with these patterns. [ABSTRACT FROM PUBLISHER]