Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
"I'm seeing red..."
- Tears are fired in an arc. Upon hitting the floor, an obstacle, or an enemy they burst into many smaller tears in all directions.
- Tears down - (Delay * 2) + 10
- Increases damage by about 31%.
- The scattered tears deal random damage that is around 50-80% of the main tear.
- +1 damage up and 1.5x damage multiplier.
- Brimstone - Significantly increased tear delay. Isaac fires a large arcing tear that fires several Brimstone beams in random directions upon bursting.
- Chocolate Milk - Increased tear delay. Completely charged shots and their burst tears are larger and deal higher damage than normal. Chocolate Milk also allows low-damage Haemolacria shots to be fired rapidly.
- Compound Fracture - Similar to Cricket's Body, tears will split, scattering massive amounts of smaller tears across the room. Hits on walls or the floor absorb most of the extra tears.
- The Parasite - Similar to Cricket's Body, tears will split, scattering massive amounts of smaller tears across the room. Hits on walls or the floor absorb most of the extra tears.
- Cricket's Body - A single tear can scatter massive amounts of smaller tears in a wide area regardless of what it hits.
- Dead Eye - Both the main tear and the burst tears can increase the damage bonus, but missing the burst tears won't reset it.
- Dr. Fetus - Significantly increased tear delay. Isaac fires a large arcing tear reminiscent of a bomb that scatters into 3-5 bombs that explode simultaneously.
Dr. Fetus + Sad Bombs: Bomb explodes into 4 sad bombs which then explode into burst tears.
- Ipecac - Tear delay is increased by 1/3 compared to either of the items on their own, but Isaac now fires Ipecac shots that releases poisonous, high-damage but non-explosive split tears on impact.
- Lachryphagy - Tears look like Haemolacria. They can be fed and will burst into 8 tears that have Haemolacria's burst effect upon hitting obstacles or enemies.
- Lead Pencil - Fires a barrage of Haemolacria tears, all of which will burst.
- Monstro's Lung - Fires a barrage of Haemolacria tears, all of which will burst.
- Mom's Knife - Haemolacria tears fire while Mom's Knife is charging.
Mom's Knife + Lilith: Mom's Knife overrides Haemolacria.
No longer works.
- Tech X - The tears burst into 3-5 Tech X rings on impact.
- Technology - Fires arcing tears that release Technology lasers upon bursting.
- Trisagion - Both Trisagion and Haemolacria fire at the same time, Haemolacria does not keep spectral tears despite its tears sprite change but the arced tear keeps piercing.
- My Reflection - Range becomes extremely high, making Haemolacria tears follow Isaac for a long time before hitting the ground. Burst tears do not have a boomerang effect.
- Treasure Room
- Treasure Room (Greed Mode)