Chaos Card - Four cards are shot out if Chaos Card hits the prism.
Jacob's Ladder - All of the split tears will be electrified. Also, electric arcs that pass through the prism will be split.
The Ludovico Technique - While the tear is in contact with the prism, it will fire 4 additional tears in cardinal directions at Isaac's tear rate.
Mom's Knife - When the knife touches the prism, split knives are launched that do not return to Isaac. The extra knives deal only 1x damage, unlike normal thrown knives.
Anti-Gravity - Tears that are floating in the air when they hit the prism will quadruple but will not move. Tears that begin moving before they hit the prism will travel outwards normally. By releasing the built up tears as the prism passes by, significantly more tears can be affected than normal.
Tractor Beam - Tears will split but continue stacked on top of each other along the tractor beam, essentially quadrupling the shot's damage.
Duct Tape - By keeping the prism in the same spot, damage output can be significantly increased in that direction. Duct Tape + Incubus: By stacking the incubus familiar on top of the prism before picking up Duct Tape, the shots will be affected no matter what direction Isaac is firing.
Immaculate Heart - The extra spectral tears generated will almost certainly hit the prism as they share the same orbit.