In Sweden, individuals with detected visual field loss (VFL) will have their driver’s license withdrawn based on perimetry results. In a previous study, a simulator-based method was used to test VFL individuals driving performance. Over 200 VFL individuals passed the simulator test and regained their driver’s licenses. Method: Seventy of the VFL individuals who had their driver’s license withdrawn due to VFL but then regained it after passing the simulator test and still had a valid driver’s license in February 2022 took part in a regular on-road driving test study. In addition, one age matched, and one younger control group (both groups matched on driving experience as well as area of living) also participated in this on-road study. Traffic inspectors, blind to group affiliation assessed the participants in cars provided by the exam office. Results: Just over 67% of the VFL participants passed the on-road test while almost 66% of the age- matched and just over 81% of the young controls passed the test. No statistical differences exist between the three groups. Discussion: The process used in Sweden for withdrawing driver’s licenses due to VFL seems to be unfair as all results indicate that participants with a detected VFL passed the on-road driving test to the same extent as did their matched controls. Second, a comparative study is needed to clarify if a simulator-based method or on-road testing is to prefer. Conclusion: Perimetry alone cannot predict driving performance on a driving test in a simulator nor on an on-road driving test assessed by traffic inspectors.