20/20

20/20 is a passive item.

Effect

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

Synergies

 * : Tears will be quadrupled when passing through the prism, resulting in 8 tears.
 * : Two brimstone shots are fired, without an increase in charge time.
 * //: Fires two tears that all split into burst tears.
 * : At full charge, fires 2 rows of 4 tears, resulting in 8 tears.
 * : Effects stack, resulting in 4 tightly packed tears being shot.
 * /: Replaces the single missile strike with a barrage of two consecutive missiles.
 * : Two bombs are thrown at once.
 * : Two explosives are fired at once.
 * : 5 shots are fired with a decrease in fire rate.
 * : Increase number of tears in tear barrage; however, only fires one stone.
 * : The Ludovico tear gains one smaller tear orbiting the main one.
 * : Two knives are fired at once.
 * : Adds more tears to the tear barrage.
 * : 6 shots are fired with a decrease in fire rate.
 * : 2 big shots are fired.
 * : Both tears will bounce off walls and obstacles.
 * : Rapidly shoots two streams of tears.
 * : Fires two tears at once that almost completely overlap each other.
 * : Two technology shots are fired simultaneously.
 * : Fires two laser rings at once.
 * : Both tears are fired along the beam. Only one tear can be seen, as they overlap each other.
 * : Fires two beams that almost completely overlap.

Interactions

 * Azazel: Fires two short ranged brimstone beams that overlap.
 * : Every second row of tears has increased damage.
 * : Overrides 20/20.
 * : Every second row of tears has increased damage.
 * The Forgotten: Doubles bones thrown and swung.
 * : Overrides 20/20.
 * Keeper: Fires 5 tears.
 * : Only occasionally fires one tear in the other three directions.
 * : Only occasionally fires one tear out of the back of Isaac's head.
 * : Overrides 20/20.
 * : Overrides 20/20.
 * : Overrides 20/20.
 * : Overrides 20/20.
 * : Two tears are fired in each direction.

Trivia

 * 20/20 is an idiom that refers to someone with near perfect vision.
 * Curiously, Isaac can throw tears even though his eyes are covered by lenses.
 * Despite only having one eye, Cain shoots two tears at once with this item.
 * 20/20's icon is white-tinted in Afterbirth.

Seeds
77H1 T20K (Treasure room adjacent to spawn) STDX QSC8 (Treasure room adjacent to spawn) NYJK 3QDN (Treasure room adjacent to spawn) AFJE 9RXX (Treasure room adjacent to spawn) Y6FY DZH6 (Treasure room next to spawn) GD7V 66ZX (Treasure room adjacent to spawn) 92SM AXWG (Treasure room next to spawn) H3Y3 X22S (First floor treasure room)