Pupula Duplex is a passive item added in The Binding of Isaac: Afterbirth expansion.
Effects
- Grants spectral tears.
- Tear size multiplier: 2x.
- Despite their crescent shape, the tears are still considered round hitbox-wise.
Synergies
Godhead: The damaging aura benefits from the increased size significantly.
Interactions
- Brimstone: No effect on Brimstone.
- The Ludovico Technique: Only tear appearance changes, no tear size up.
- Mom's Knife: No effect on Mom's Knife.
- Tech X: No effect on Tech X.
- Technology: No effect on Technology or its variants.
In-game Footage
Trivia
- "Pupula Duplex" is said to be a condition in which a person has two irises and two pupils in one eye, without any actual recorded cases. An actual rare medical condition similar to it exists, called polycoria.
- This item's icon is similar to Diplopia.
Seeds
PC HN4T QMN7 (First floor treasure room)
PC HLTD B7WD (Treasure room adjacent to spawn) 
PC XVA6 BQFC (First floor treasure room)
Switch 
C6VD 4WXP (First Golden Treasure Room)
 The Binding of Isaac: Rebirth
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