It means that - but in the worst possible way. It would make the whole thing very tedious, to the point where all the attempted realism would be lost because looking around would be too much work.
Realism is only actually realism when it produces realistic effects. If a “realistic” feature makes everyone act less realistically, it was never realistic in the first place.
I have recently played a game that did restricted FoV angle really well - Darkwood. The problem is, it’s not possible to translate this to DDA due to control scheme differences and turn based vs real time.
So the best we’d get would be some copy of DF or UW mechanics. And those would SUCK here due to crafting, reloading, enemy AI, limitations on provided information (“you hear footsteps” - rabbit’s or hulk’s?) and so on.
Not saying they don’t suck in DF or UW, just that they would surely suck here.
IRL, if you want to look around, you turn your head from side to side. This is completely intuitive and thus not tedious. In the game this would require manually looking around, making the characters act less realistically when they don’t do that, which would be most of the time.
IRL, if you wanted to say, rip apart a t-shirt while making sure nothing ambushes you, you’d look up every now and then and scan the area for threats, or put your back against the wall and lift the shirt to the air so that you see everything in front of you. The former is already simulated (the only thing that would need to change would be some perception roll penalty), the latter one would be much, much more tedious in the game than in real life, so it would be anti-realistic to make people avoid doing it in the game.
So limited angle FoV is certainly nowhere as simple to do non-badly as it seems. And so far no one provided a brilliant idea to fix the massive problems that would come with it.