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| Acquire Blood Clot 10 timesHaemolacria|
Haemolacria is an unlockable passive item added in Booster Pack #4.
- 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.
- Higher shot speed lowers the arc of the main shot, whereas lower speed heightens it, resulting in very minor change in effective range.
- The split tears are affected normally by shot speed.
- The tear height stat is entirely ignored for both the main shot and the split tears.
- Anti-Gravity-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.: If a fire button is held down when a Haemolacria tear bursts, the burst tears will hover in place before being fired outwards.
- Apple!Increases tears. Adds a chance to fire a high-damage razor blade. / EuthanasiaAdds a chance to fire needles. If a needle kills an enemy, it bursts into more needles. / Tough LoveAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.: The visual effects on tears don't work, but the damage bonuses do.
- Azazel: Haemolacria overrides Azazel's Brimstone.
- Death's TouchIncreases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.: Tears pierce enemies instead of bursting on contact. The visual effect is not maintained.
- Epic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.: Overrides Haemolacria, with increased damage and tear delay.
- Eye of BelialGrants piercing tears. After piercing one enemy, tears start homing and deal double damage.: The tear loses its ability to burst on hitting enemies, turning into an Eye of Belial tear instead.
- This no longer happens as of Booster Pack 5; the tear bursts as normal.
- Flat StoneTears bounce off the floor. Tears that hit an enemy after bouncing deal splash damage to all nearby enemies for 25% of Isaac's tear damage.: At base range, the main tear bounces once, releasing burst tears which do not bounce, then bursts normally. At high range, the main tear can bounce multiple times.
- GodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.: The main tear has the damaging aura but burst tears do not.
- GodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo. + The Forgotten: The blood tears from the bone club have the damaging aura.
- Kidney StoneRandomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.: Overridden by Haemolacria. Only stat changes apply.
- The Ludovico TechniqueInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.: Overridden by Haemolacria.
- PolyphemusMakes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.: The large tear will shrink if an enemy dies on hit, reducing the damage of the burst tears.
- Rubber CementTears bounce off walls, enemies, and environmental objects.: Tears will burst only when they hit the floor, not on walls or enemies.
- Sinus InfectionAdds a chance to fire a booger which sticks to enemies and poisons them.: If the main tear is a booger, it will get stuck and not burst on hitting an enemy, dealing its heightened damage. Split tears have an independent chance of being booger tears.
- Tractor BeamIsaac emits a beam from his face. Isaac's tears travel in the path of the beam.: The main tear follows the beam, but the burst spreads normally.
- 20/20Grants double shot./ The Inner EyeGrants triple shot but decreases tears./ Mutant SpiderGrants quadruple shot but decreases tears.: Multiple Haemolacria shots are fired simultaneously.
- Angelic PrismGrants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.: The main tear splits if it hits the prism. Burst tears will only split if the main tear did not split.
- BrimstoneTears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.: Significantly increased tear delay. Isaac fires a large arcing tear with the Brimstone symbol on it that fires several Brimstone beams in random directions upon bursting.
- Chocolate MilkGrants charged tears that deal greater damage when fully charged.: Completely charged tears and their burst tears are larger and deal higher damage than normal. Chocolate Milk also allows low-damage Haemolacria tears to be fired rapidly.
- Conjoined transformation: Fires 3 Haemolacria tears simultaneously.
- Compound FractureIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle./ The ParasiteIsaac's tears split in two when they hit something.: 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 BodyGrants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.: A single tear can scatter massive amounts of smaller tears in a wide area regardless of what it hits.
- Dead EyeIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.: Both the main tear and the burst tears can increase the damage bonus, but missing the burst tears won't reset it.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.: 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+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.: Bomb explodes into 4 sad bombs which then explode into burst tears. Can lag the game.
- Fate's RewardA blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.: The familiar fires additional Haemolacria tears.
- The Forgotten: Several blood tears are scattered upon the bone club hitting an enemy. Also increases the size of the club, similar to PolyphemusMakes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.. The throw is unaffected and does not scatter blood tears.
- Holy LightIsaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.: The main tear can be a holy tear and bursts normally in addition to the light beam. Split tears have an independent chance of being holy tears.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.: Fires a large explosive shot that releases poisonous, high-damage but non-explosive split tears on impact.
- LachryphagyIsaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.: Tears look like Hameolacria. They can be fed and will burst into 8 tears that have Haemolacria's burst effect upon hitting obstacles or enemies.
- Lead PencilAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears.: Fires a barrage of Haemolacria tears, all of which will burst.
- Keeper: Fires 3 Haemolacria tears simultaneously, with lower fire rate.
- Mom's KnifeIsaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.: Haemolacria works with minimal tear delay while Mom's Knife has to be charged.
- Does not work with Lilith, Mom's Knife overrides Haemolacria.
- Monstro's LungIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.: Fires a barrage of Haemolacria tears. Increases charging time considerably.
- My ReflectionGives Isaac's tears a boomerang effect, and increases range and shot speed.: Removes the arcing behavior of the tears, massively increasing airtime of both the main tear and the scattered ones.
- Pop!Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.: The large tear floats in the air before exploding, and the smaller burst tears can be knocked around.
- ProptosisTears start out massive with high damage, and then shrink down and become weaker over a short range.: Large tear and burst tears do roughly double normal damage.
- Tammy's HeadShoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.: Fires a ring of Haemolacria tears.
- Tech XTears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.: The tears burst into 3-5 Tech X rings on impact.
- TechnologyReplaces tears with a piercing laser with unlimited range.: Fires arcing tears that release Technology lasers upon bursting.
- Strange AttractorPickups, trinkets, and monsters are magnetically attracted to Isaac's tears.: Enemies and objects will be pulled toward the Haemolacria shot, increasing accuracy.
- Varicose VeinsTaking damage releases a ring of 10 high damage tears.: The ten tears fired upon taking damage will all burst.
- Haemolacria is based on this Steam Workshop item by HiHowAreYou, originally known as Water Balloon.
- The item is a reference to the rare condition with the same name that causes people to produce tears that are composed of blood.
When using The Forgotten
's melee attack with both Jacob's Ladder
and Haemolacria, the sparks caused by splattered tears will hurt the player. This does not apply to other tear scattering items.