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Removed in Afterbirth †Item icon
Added in Afterbirth †Item icon
Item altar
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Character appearance
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Treasure Room Treasure Room
Greed mode only Treasure Room Treasure Room
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Added in Afterbirth(page 3, column 17, row 1)
Removed in Afterbirth(page 3, column 7, row 6)

Proptosis is a passive item.

Effects[edit | edit source]

  • Doubles Isaac's Damage stat.
  • Tear size multiplier: 2x.
  • The tears shrink and lose damage the farther they travel.

Notes[edit | edit source]

  • Effective range of Isaac's tears now also depends on the damage, as they can shrink out of existence before their air time runs out.
  • Tear size increasing items also increase the maximum distance before its disappearance, but the damage dealt can go below original at the extreme.
  • The item has the opposite effect of the item A Lump of Coal, which makes Isaac deal more damage from farther away.
  • Does not affect Azazel's short-ranged Brimstone Brimstone unless the range stat is extremely high.

Synergies[edit | edit source]

  • Anti-Gravity Anti-Gravity: The tears will not decrease in size or damage until they start moving, making this excellent against enemies that chase Isaac.
  • Brimstone Brimstone: Retains the double damage effect without losing damage over range.
    • Added in Afterbirth Damage is doubled again for a total of 4x next to Isaac, but quickly drops further along the beam, at about 0.8x per tile of distance.
  • Dr. Fetus Dr. Fetus/Epic Fetus Epic Fetus: Doubles damage with no penalty for distance.
  • Godhead Godhead: The damaging halo shrinks with the tears.
  • A Lump of Coal A Lump of Coal: Proptosis scales with Isaac's damage while the Lump of Coal does not. At base damage, the Lump of Coal will approximately negate the damage lost over distance, but with increased damage, tears still do more damage up close.
  • Mom's Knife Mom's Knife: The Knife damage is doubled regardless of range.
  • Polyphemus Polyphemus: Tears do massive damage and carry with leftover damage while still shrinking.
  • Technology Technology/Technology 2 Technology 2: Doubles damage.
    • Added in Afterbirth The beam decreases in damage and width the farther it travels. Tears become virtually powerless across large rooms like the Boss Rush and the Hush fight.
  • Added in AfterbirthTech X Tech X: Ring size and damage is substantially increased, but decreases as the ring travels further from Isaac.
  • Added in Afterbirth †Trisagion Trisagion: Base damage is doubled and beam damage is boosted to about 65%. Blasts lose no power as they travel further, though the tips of the blasts deal very slightly less damage.

Interactions[edit | edit source]

  • Added in AfterbirthAthame Athame/Added in AfterbirthMaw of the Void Maw of the Void: The ring is much larger and deals 1.5x damage.
    • Added in Afterbirth † The ring deals normal damage.
  • Added in Afterbirth †Compound Fracture Compound Fracture/Cricket's Body Cricket's Body/The Parasite The Parasite: Tears will often disappear before they can burst. Tears created from bursts will also shrink, but due to their already low range, the difference may not be noticeable.
  • Added in Afterbirth †Flat Stone Flat Stone: At base range and tear size, tears will bounce twice against the floor and then disappear.
  • Ipecac Ipecac: Tears almost disappear completely but are still able to do massive damage.
  • Added in Afterbirth †Lachryphagy Lachryphagy: Tears disappear too quickly to be fed.
  • The Ludovico Technique The Ludovico Technique: The closer the tear floats to Isaac, the larger it is. The farther away, the smaller it becomes.
  • Monstro's Lung Monstro's Lung/Added in Afterbirth †Lead Pencil Lead Pencil: Tears will disappear at different distances depending on how big they were when fired.
  • My Reflection My Reflection: Tears disappear before they can return to Isaac.
  • Added in Afterbirth †Pop! Pop!: Tears will disappear extremely quickly after being fired.
  • Soy Milk Soy Milk: Very poor combination. Tears disappear nearly instantly in front of Isaac, decreasing his range and damage to nearly nothing.

In-game Footage[edit | edit source]

Trivia[edit | edit source]

  • Eye proptosis is a condition resulting in forward displacement and entrapment of the eye from behind by the eyelids. The condition is also known as eye dislocation and eye luxation.

Seeds[edit | edit source]

 PC  CMTS HNLP (Treasure room adjacent to spawn)

 PC  1SKS ZMYW (Treasure room adjacent to spawn)

 PS4  BZZ7 DWY3 (Treasure room adjacent to spawn)

 3DS  HAPT EHDH (First floor treasure room)

 PC  Added in Afterbirth GDD6 7YNH (Treasure room adjacent to spawn, Burning Basement)

 Switch  L79D L9S8 (Treasure room adjacent to spawn)

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