20/20

Effect

• Isaac fires two tears at once, one from each eye.
• (Added in Repentance) 0.75x damage multiplier.

Notes

• Unlike other multiple shot items like Mutant Spider or The Inner Eye, 20/20 does not reduce the rate of fire.
• The maximum amount of tears per volley that can be reached by combining and/or duplicating 20/20, The Inner Eye, Mutant Spider and (Added in Afterbirth) The Wiz is 16, or 20 with the (Keeper) Keeper.

Synergies

• Blood Clot / Chemical Peel: Every second row of tears has increased damage.
• (Added in Afterbirth) Brimstone: Two Brimstone shots are fired, without an increase in charge time.
• (Added in Afterbirth / Removed in Repentance) Diplopia: Every additional 20/20 adds 2 more tears in a tight pattern.
  • (Added in Repentance) Adds one more tear without further lowering damage.
• (Added in Afterbirth) Doctor's Remote / Epic Fetus: Replaces the single missile strike with a barrage of two consecutive missiles.
• (Added in Afterbirth / Removed in Repentance) The Inner Eye / Mutant Spider: Adds two/three tears to each shot, with no extra fire rate decrease.
  • (Added in Repentance) Removes the fire rate penalty while reducing damage to 75%. Additional copies will add one additional tear with no further change to damage/fire rate.
• (Added in Afterbirth / Removed in Repentance) (Keeper) Keeper: Fires 5 tears with no fire rate decrease.
  • (Added in Repentance) Decreases tears' spread. Reduces damage dealt to 75%, but makes his base tear stat equal 2.73. This is a damage per second increase if tear rate before picking up was less than 3.75; otherwise this is a damage per second decrease.
• The Ludovico Technique: The Ludovico tear gains one smaller tear orbiting the main one, each dealing the same amount of damage.
• (Added in Afterbirth) Monstro's Lung: Adds two tears to the tear barrage, for a total of 16.
• Polyphemus: Removes the fire rate penalty from Polyphemus and still fires 2 tears each shot with a smaller damage up.
• (Added in Afterbirth †) Sprinkler: Fires two tears at once that almost completely overlap each other.
• (Added in Repentance) (Tainted Keeper) Tainted Keeper: Decreases tears' spread. Reduces damage dealt to 75%, but makes his base tear stat equal 2.73. This is a damage per second increase if tear rate before picking up was less than 3.75; otherwise this is a damage per second decrease.
• (Added in Afterbirth) Technology: Fires two technology shots simultaneously.
• (Added in Afterbirth) Tractor Beam: Both tears are fired along the beam. Only one tear can be seen, as they overlap each other.
• (Added in Afterbirth) The Wiz: Two tears are fired in each direction.

Interactions

• (Removed in Afterbirth) Brimstone: Overrides 20/20.
• (Removed in Afterbirth) The Inner Eye: Overrides 20/20.
• (Added in Afterbirth) Kidney Stone: Increase number of tears in tear barrage; however, only fires one stone.
• Loki's Horns: Only occasionally fires one tear in the other three directions.
• Mom's Eye: Only occasionally fires one tear out of the back of Isaac's head.
• (Removed in Afterbirth) Mom's Knife: Overrides 20/20.
• (Removed in Afterbirth) Monstro's Lung: Overrides 20/20.
• (Removed in Afterbirth) Mutant Spider: Overrides 20/20.
  • (Added in Repentance) Cancels the tears down of Mutant Spider.
• Sad Bombs: Does not affect the number of tears when bombs explode.
• (Removed in Afterbirth) Technology: Overrides 20/20.
• (Added in Afterbirth †) Varicose Veins: No effect on number of tears when taking damage.