You hear an echo of your voice, breathing, and external sounds that seem to resonate in your sinuses. This gives you a −(IE) penalty on all saving throws against sound-based attacks and Wisdom (Perception) checks based on hearing. Because it causes you to hear differently, it also gives +(IE) to saving throws against Charm Person and other charm attacks with a verbal component.

Real-world Examples

Eustachian Tube Dysfunction

Assistive Options

Valsalva Maneuver: Attempting to blow while holding the nose and mouth shut puts pressure on the sinus cavity and inner ear and can reduce nasal echo by 1 IE for 2d4 minutes.

Your sense of smell is more sensitive than usual, giving you a +(IE) on Wisdom (Perception) checks related to smell but a −(IE) penalty on all saving throws against gasses and other smell-based attacks.

Real-world Examples

Hyperosmia

Assistive Options

Wearing a thick mask that filters the air and is infused with pleasant smells (e.g., plant oils or potpourri) can reduce this sensitivity by 1 IE for 10 minutes, but it must then be thoroughly washed and replenished before gaining the benefits. Wearing such a mask beyond that time after exposure to a gas-based attack gives an additional −1 penalty on all saving throws against gasses or other smell-based attacks.

You have a beak-like nose and upper lip with a rhinoceros-like horn. This allows you to use your horn as an unarmed attack, causing piercing damage instead of bludgeoning. It also gives you advantage on Charisma (Intimidation) checks but disadvantage on Charisma (Persuasion) checks.

Real-world Examples

This is a fantasy trait with no real-world analog.

Assistive Options

This has no mundane assistive technology.

Magical Assistance

The Seeming spell can alter a person’s appearance to mask this and other cosmetic differences.

You have a nose that’s outside of the expected range of shapes for your ancestry. This gives you +(IE) to Dexterity (Sleight of Hand) checks but −(IE) to Charisma (Persuasion) checks with people who don’t know you due to many people’s discomfort around those with unexpected appearances.

Real-world Examples

Rhinophyma, Deviated Septum, Rosacea, Wegener’s Granulomatosis, Sarcoidosis, Relapsing Polychondritis

Assistive Options

The character can wear a helmet or other face covering to conceal the difference, but note that people in some cultures may tend to be less trusting of those with covered faces, giving disadvantage on Charisma (Persuasion) checks.

Magical Assistance

The Seeming spell can alter a person’s appearance to mask this and other cosmetic differences.

A substance leaks out of your nose. Roll on the table below for the nature and effects of the substance.

Blood. Blood drains out of your nose at a rate of (IE)² ounces per day. Because of this blood loss, you need to eat more to compensate, consuming an additional (IE) days’ worth of food per week to avoid exhaustion.

Honey. A honey-like substance flows from your nose at a rate of (IE)² ounces per day. While this substance is edible and tastes similar to honey, most people are reluctant to consume it, considering its source. Because of its sweet smell, it attracts insects and other animals, and if not properly cleaned, it will leave contacted substances sticky.

Mucus. Mucus fills and flows from your nose at a rate of (IE)² ounces per day. Because of constantly wiping your nose, your nose and mouth are raw, and you must blow your nose to smell properly. You have a −(IE) penalty on all saving throws and surprise rolls involving smell, and you have a −(IE) penalty on other smell-related ability checks and saving throws.

Pus. A foul-smelling ochre pus flows from your nose at a rate of (IE)² ounces per day. The smell gives you a −(IE) penalty on Dexterity (Stealth) and Charisma (Persuasion) checks. If collected, 32 ounces of the pus can be thrown at a target and cause the same effects to that target as a Stinking Cloud spell.

Smoke. Sulfurous-smelling black smoke streams out of your nose. The smell gives you a −(IE) penalty on Dexterity (Stealth) and Charisma (Persuasion) checks but advantage on Charisma (Intimidation) checks due to suspicion of fiendish origin. If left 1 ÷ (IE) hours in a room without ventilation, everyone in the room except you must succeed on a Constitution saving throw or be affected as if by a Stinking Cloud spell.

Tears. Tears drain out of your nose at a rate of (IE)² × 8 ounces per day. Because of this fluid loss, you need to drink additional water to assist with the loss to avoid Dehydration and exhaustion.

Real-world Examples

Sinusitis, Rhinitis, Nasal Polyps

Assistive Options

Rinsing out the nose with a spray or neti pot can reduce the IE by 1 for an hour on a successful DC 10 Constitution check. Failure to use sterilized water requires a DC 8 Constitution saving throw to avoid Infection.

Magical Assistance

Juanita’s Wonderful Wind Plugs can be fitted to the nostrils. When so used, because of the air current it creates in the sinus cavity, it’s impossible to speak intelligibly, and no spells with verbal components can be used while wearing these in the nose. The Prestidigitation spell can clean the affected area but does not stop the discharge.

You have a decreased or no sense of smell. You experience a penalty of −(IE) on all Wisdom (Perception) checks related to smell but gain a +(IE) on all saving throws against smell-based attacks.

Real-world Examples

Covid−19, Nasal Polyps, Sinusitis, Hyposmia, Parkinson’s Disease, Alzheimer’s Disease, Fibromyalgia, Diabetes, Acquired Brain Injury

Assistive Options

No available technology can assist with anosmia.

You can only see in the infrared portion of the spectrum, so you see heat as color but have Colorblindness and otherwise can’t see light and dark, writing, or any other details except shapes as infrared light reflects off surfaces. In cold environments, this becomes especially challenging, as warm-blooded creatures shine like beacons but undead are nearly invisible. GMs should use their discretion how this affects vision, cover, and other visual factors. Your spellbook requires heat-sensitive ink that is difficult to find and costs triple the normal cost. To prepare a spell, you must expose your spellbook to a nearby heat source, at which point the ink gets warmer than the paper, allowing you to read it. You may find other writing alternatives like tactile methods if this ink is unavailable.

Real-world Examples

This is a fantasy trait with no real-life analog.

Assistive Options

While this disability has some advantages, it has no assistive technology options.

Your eyes move on their own, giving you double vision, shaky vision, crossed eyes, amblyopia, and involuntary eye movements. You have to use a bonus action to focus your eyes (DC 5 + (IE) Constitution check) before making any action requiring visual focus. Once you succeed, you can retain this focus until either the situation changes (e.g., an encounter begins or ends) or you take damage.

Real-world Examples

Strabismus, Nystagmus, Diplopia, Amblyopia

Assistive Options

An eye patch can correct for all but shaky vision but gives disadvantage on all Wisdom (Perception) checks involving seeing on the patched side.

Your vision is blurry when looking at things close (40 percent) or distant (40 percent) or both (20 percent).

Nearsightedness: The farther away things get, the blurrier they get. You have a −(IE) penalty on attack rolls and Wisdom (Perception) checks to see any details farther than 50 – (IE) × 10 feet as well as other ranged actions such as jumping or throwing. If you have IE 4 Nearsightedness, you may choose Aquatic Vision as an additional Trait.

Farsightedness: The closer things get, the blurrier they get. You have a −(IE) penalty on attack rolls and Wisdom (Perception) checks to see any details closer than (IE) × 5 feet. Your spellbook needs to be written in very large letters or by some other means to allow you to read it.

Blurred Vision: Everything is blurry. You have −(IE) on all attack rolls and Wisdom (Perception rolls) to see details or read. Your spellbook needs to be written in very large letters or by some other means to allow you to read it.

Real-world Examples

Nearsightedness, Farsightedness, Astigmatism, Presbyopia

Assistive Options

Spectacles can be made by an artisan with a Wisdom (Medicine) roll to reduce the IE by 1 (DC 10) or 2 (DC 15) for 200 gp + (IE) × 100 gp and seven days of work. If the artisan fails the roll, it can be attempted again, each time requiring the same amount of time and cost for each attempt.