Isaac fires huge tears that deal massive damage but fire rate is greatly decreased. If a tear kills an enemy, the tear travels on with any leftover damage.
Quote
"Mega Tears"
Effects
Greatly increased damage:
Tears down:
If a tear kills an enemy, the tear travels on with any leftover damage.
Synergies
Dr. Fetus - Increases tear delay, and after the first bomb explodes, a second bomb appears where the first one exploded, doing roughly half the damage of the first.
The Inner Eye - The tear rate is not lowered further, but the effect on damage becomes a flat +5 bonus instead.
Mutant Spider - The tear rate is not lowered further, but the effect on damage becomes a flat +5 bonus instead.
Shard of Glass - The rapidly spawning red tears do full damage.