A purple 3 Dollar Bill.
Isaac becomes happy, with a sparkle coming from his right eye.
Isaac's tears get a random effect upon entering a room. These are listed below.
|The Inner Eye||Gives Isaac a triple shot, sets Tears to minimum|
|Magneto||Attracts Pick Ups to Isaac|
|Mom's Contacts||Gives Isaac a petrifying shot that will randomly freeze enemies solid for a few seconds.|
|My Reflection||Gives Isaac's tears a boomerang effect and range is set to default.|
|Number One||Sets Isaac's tears to their maximum rate of fire and minimum range.|
|Ouija Board||Allows Isaac's shots to go through rocks or obstacles.|
|Spoon Bender||Gives the Isaacs's shots the ability to curve towards enemies.|
|Tough Love||Isaac randomly shoots teeth instead of tears, dealing more than triple damage, the extra damage can go over the damage limit allowing you to deal triple the max damage.|
|Speed Ball||Increased Speed and Shot Speed.|
|Lucky Foot||Turns negative pills into positive pills, increases chance of winning the Shell Game.|
- Since it can grant the Magneto effect, it can be used to acquire items (bombs, keys etc.) you otherwise couldn't by repeatedly leaving and re-entering a room.
- Since it can give the My Reflection effect, having this item with IPECAC can be potentially dangerous, as the poison bombs will target Isaac.
- Mom's Knife can cause confusion as to which effect is in place. The knife can change its color to match a possible effect, but the actual effect can be different. (i.e. A Yellow Knife for Number One, but Mom's Contacts Freezing Effect.
- If you have 3 Dollar Bill and then find Polyphemus, an exploit is to walk between rooms until you have the Inner Eye effect in the same room with Polyphemus. Then you can take Polyphemus and once you leave the room, Polyphemus' normal huge tears down will not apply, giving you huge damage with no real tears down.
- The name of this item is a reference to the expression "Queer as a 3 Dollar Bill".