PURPOSE. To determine the longitudinal impact of idiopathic macular telangiectasia (MacTel) type 2 on vision-specific quality of life (QoL). METHODS. Participants with MacTel type 2 and controls with no vision impairment were recruited at baseline. All underwent a full ophthalmic examination and the interview-administered 28-item Impact of Vision Impairment (IVI) questionnaire at baseline, to gather information on sociodemographic factors and vision-specific QoL. The MacTel patients were reassessed at 24 months. RESULTS. For the MacTel participants (n = 22), the median (range) age and visual acuity were 64 years (45- 87) and 20/32 (20/13-20/63) in the better eye, respectively. The corresponding median values in the control group (n = 38) were 57 years (41- 68) and 20/25 or better in both eyes, respectively. Rasch analysis showed that the IVI and its three subscales had sufficient psychometric validity and possessed interval level estimates. The control group had almost twice the level of visionspecific QoL than did the MacTel group at baseline on all IVI scores (P < 0.001 for all). At 24 months, we found no significant change in any of the IVI scores in the MacTel group. Similarly, there was no significant difference in visual acuity in the better or worse eyes in that group after 2 years. CONCLUSIONS. Persons with MacTel type 2 had poorer overall vision-related QoL than did healthy controls. Several aspects of vision-related QoL and distance visual acuity did not significantly change after 24 months. Longer follow-up assessment periods are needed to determine the longitudinal impact of this condition on vision-related QoL.