The Wiz 
Effects
- Isaac fires tears from both eyes at the same time.
- Isaac's tears are fired diagonally outwards, similar to the effect of the R U a Wizard? pill.
- Isaac's tears become spectral.
Notes
Synergies
Diplopia: Picking up a second The Wiz will make Isaac fire 4 tears in a wider diagonal layout.
- (Added in Repentance) Picking up a second The Wiz will make Isaac fire 1 additional tear in front of him, giving the same effect as the Conjoined transformation.
- (Added in Repentance)
Eye of the Occult: Both tears shoot much closer together and can be controlled, creating for a better double shot similar to what Tractor Beam would grant.
- (Added in Afterbirth †)
Technology Zero: Electricity arcs between both tears instantly, providing incredible crowd control.
- Technology Zero + Piercing: Tears cannot be stopped by enemies, resulting in an unstoppable array of electricity between tears.
Tractor Beam: Both tears will follow the beam, making it easier to hit enemies with them, effectively like 
20/20 with Spectral tears.
- (Added in Repentance) The Wiz is superior to 20/20 with Tractor Beam, due to having no damage penalty.
- Tractor Beam +
Mom's Knife: Both knives ignore the path of the beam and remain flying diagonally.
Interactions
- (Added in Afterbirth †)
Analog Stick: Will make one tear go forwards and the other tear fire at a 90-degree angle to the other tear.
- (Azazel) Azazel: Azazel fires two short diagonal
Brimstone beams in the chosen direction (Same with (Tainted Azazel) Tainted Azazel).
- Brimstone beams remain diagonal even if Isaac has Tractor Beam.
- (Cain) Cain: Makes Cain fire in the two diagonal directions instead of just his right eye as the R U a Wizard? pill does.
- Conjoined: Fires double tears in both directions, but removes the center tear.
Epic Fetus: The crosshair is controlled diagonally as if rotated 45 degrees clockwise from usual (i.e.: the up arrow will move it in a northeast direction), and two missiles are fired, similar to the effect of 20/20. The crosshair can be moved in the cardinal directions by pressing two arrow keys at once (e.g.: pressing the up and right arrows will move the crosshair right).- Homing tears: Tears are more likely to home in on enemies if enemies are coming towards Isaac diagonally. Otherwise, it only minorly improves accuracy.
The Ludovico Technique: Small tear orbits the main tear. Tear controls rotated 45 degrees clockwise - holding up makes it move northeast and so on.
Marked: Fires two shots aimed diagonally from the crosshair.
Monstro's Lung: 7-8 tears are fired at each diagonal direction instead of a full burst.- R U a Wizard? pill: Makes Isaac fire forward with a normal fire rate and 90 degrees outwards with half fire rate.
Sad Bombs: Does not affect the number of tears when bombs explode.- (Added in Afterbirth †)
Varicose Veins: No effect on number of tears when taking damage.
The Inner Eye, 
Mutant Spider and The Wiz is 16, or 20 with (Keeper) Keeper.
Anti-Gravity: Overrides The Wiz.