Binding of Isaac: Rebirth Wiki

20/20 is a passive item.


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



  • Blood Clot Blood Clot / Chemical Peel Chemical Peel: Every second row of tears has increased damage.
  • Added in AfterbirthBrimstone Brimstone: Two Brimstone shots are fired, without an increase in charge time.
  • Added in Afterbirth / Removed in RepentanceDiplopia 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 AfterbirthDoctor's Remote Doctor's Remote / Epic Fetus Epic Fetus: Replaces the single missile strike with a barrage of two consecutive missiles.
  • Added in Afterbirth / Removed in RepentanceThe Inner Eye The Inner Eye / Mutant Spider 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. This is the same for Tainted Keeper Tainted Keeper.
  • 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 AfterbirthMonstro's Lung Monstro's Lung: Adds two tears to the tear barrage, for a total of 16.
  • Added in RepentancePolyphemus Polyphemus: Grants additional +5 flat damage and removes the fire rate penalty, firing 2 tears per shot.
  • Added in Afterbirth †Sprinkler Sprinkler: Fires two tears at once that almost completely overlap each other.
  • Added in AfterbirthTechnology Technology: Fires two technology shots 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.


In-game Footage[]


  • 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.
  • This item is used in Added in Repentance Seeing Double (challenge #40).


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)