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Font TeamMeat 2.pngFont TeamMeat 0.pngFont TeamMeat slash.pngFont TeamMeat 2.pngFont TeamMeat 0.png
Removed in Afterbirth Item icon
Added in Afterbirth Item icon
Item altar
Table dividing line 1.png


Character appearance

Tear appearance
Table dividing line 2.png
Table dividing line 3.png

Added in Afterbirth(page 3, column 1, row 1)
Removed in Afterbirth(page 3, column 1, row 5)

20/20 is a passive item.

Effect[edit | edit source]

  • Isaac fires two tears at once, one from each eye.

Notes[edit | edit source]

  • Unlike other multiple shot items like Mutant Spider Mutant Spider or The Inner Eye The Inner Eye, 20/20 does not reduce the rate of fire, effectively doubling the damage-per-second potential. Removed in Afterbirth However, it does not synergize with as many items as the other shot multipliers do.
  • The maximum amount of tears per volley that can be reached by combining and/or duplicating 20/20, The Inner Eye The Inner Eye, Mutant Spider Mutant Spider and Added in AfterbirthThe Wiz The Wiz is 16.

Synergies[edit | edit source]

  • Blood Clot Blood Clot / Chemical Peel Chemical Peel: Every second row of tears has increased damage.
  • Added in Afterbirth Brimstone Brimstone: Two Brimstone shots are fired, without an increase in charge time.
  • Added in Afterbirth †Crooked Penny Crooked Penny / Added in AfterbirthDiplopia Diplopia: Every additional 20/20 adds 2 more tears in a tight pattern.
  • Added in Afterbirth Doctor's Remote Doctor's Remote / Epic Fetus Epic Fetus: Replaces the single missile strike with a barrage of two consecutive missiles.
  • Added in Afterbirth The Inner Eye The Inner Eye / Mutant Spider Mutant Spider: Adds two tears to each shot, with no extra fire rate decrease.
  • Added in Afterbirth Keeper: Fires 5 tears with no fire rate decrease.
  • Added in AfterbirthKidney Stone Kidney Stone: Increase number of tears in tear barrage; however, only fires one stone.
  • The Ludovico Technique 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 Monstro's Lung: Adds two tears to the tear barrage, for a total of 16.
  • Added in Afterbirth †Sprinkler Sprinkler: Fires two tears at once that almost completely overlap each other.
  • Added in Afterbirth Technology Technology: Two technology shots are fired simultaneously.
  • Added in AfterbirthTractor Beam Tractor Beam: Both tears are fired along the beam. Only one tear can be seen, as they overlap each other.
  • Added in AfterbirthThe Wiz The Wiz: Two tears are fired in each direction.

Interactions[edit | edit source]

In-game Footage[edit | edit source]

Trivia[edit | edit source]

  • 20/20 is an idiom that refers to someone with near-perfect vision.
  • Despite only having one eye, Cain shoots two tears at once with this item.
  • Added in Afterbirth 20/20's icon is white-tinted in Afterbirth.

Seeds[edit | edit source]

 PC  Added in Afterbirth 77H1 T20K (Treasure Room adjacent to spawn)

 PC  STDX QSC8 (Treasure Room adjacent to spawn)

 PC  NYJK 3QDN (Treasure Room adjacent to spawn)

 PC  AFJE 9RXX (Treasure Room adjacent to spawn)

 PC  Y6FY DZH6 (Treasure Room next to spawn)

 PS4  GD7V 66ZX (Treasure Room adjacent to spawn)

 Vita  92SM AXWG (Treasure Room next to spawn)

 3DS  H3Y3 X22S (First floor Treasure Room)

 XboxOne  228H QN22 (First floor Treasure Room above spawn)

 Switch  GBDPZXGJ (Eden starts with it)

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