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Item icon
Item altar
"I'm seeing red..."
Table dividing line 1.png
Item ID
Character Appearance
Character appearance
Tear Appearance
Tear appearance
Table dividing line 2.png
Table dividing line 3.png
Collection Grid
Removed in Repentance(page 5, column 6, row 3)
Added in Repentance(page 5, column 7, row 3)
Unlock Method
Haemolacria Acquire 15►Blood Clot Blood Clot 10 times
Added in Afterbirth †

Haemolacria is an unlockable passive item added in The Binding of Isaac: Afterbirth †.

Effects[edit | edit source]

  • 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.

Notes[edit | edit source]

  • Higher shot speed lowers the arc of the main shot, whereas lower speed heightens it, resulting in a 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.
  • The main tear has a roughly 1.71x size multiplier.

Synergies[edit | edit source]

  • 15►Brimstone Brimstone: Significantly increased tear delay. Isaac fires a large arcing tear that fires several Brimstone beams in random directions upon bursting.
  • 15►Compound Fracture Compound Fracture/15►The Parasite 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.
  • 15►Cricket's Body Cricket's Body: A single tear can scatter massive amounts of smaller tears in a wide area regardless of what it hits.
  • 15►Dead Eye Dead Eye: Both the main tear and the burst tears can increase the damage bonus, but missing the burst tears won't reset it.
  • 15►Dr. Fetus 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 + 15►Sad Bombs Sad Bombs: Bomb explodes into 4 sad bombs which then explode into burst tears.
  • The Forgotten: Several blood tears are scattered upon the bone club hitting an enemy. It also increases the size of the club, similar to 15►Polyphemus Polyphemus. The throw is unaffected and does not scatter blood tears.
  • 15►Ipecac 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.
  • 15►Lachryphagy 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.
  • 15►Lead Pencil Lead Pencil/15►Monstro's Lung Monstro's Lung: Fires a barrage of Haemolacria tears, all of which will burst.
  • 15►Mom's Knife Mom's Knife: Haemolacria tears fire while Mom's Knife is charging.
    • Mom's Knife + Lilith: Mom's Knife overrides Haemolacria.
  • 15►Tech X Tech X: The tears burst into 3-5 Tech X rings on impact.
  • 15►Technology Technology: Fires arcing tears that release Technology lasers upon bursting.
  • 15►Trisagion 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.
  • 15►My Reflection 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.

Interactions[edit | edit source]

  • Azazel: Haemolacria overrides Azazel's Brimstone.
  • 15►Epic Fetus Epic Fetus: Overrides Haemolacria, with increased damage and tear delay.
  • 15►Flat Stone Flat Stone: At the base range, the main tear bounces once, releasing burst tears which do not bounce, then bursts normally. At a high range, the main tear can bounce multiple times.
  • 15►Godhead Godhead: The main tear has the damaging aura but burst tears do not.
    • Godhead + The Forgotten: The blood tears from the bone club have the damaging aura.
  • 15►Holy Light Holy Light: 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.
  • 15►Kidney Stone Kidney Stone: Overridden by Haemolacria. Only stat changes apply.
  • 15►The Ludovico Technique The Ludovico Technique: Overridden by Haemolacria.
  • 15►Mysterious Liquid Mysterious Liquid: Only the main tear will leave creep.
  • Piercing tears / Spectral tears: The main tear gains these effects, but the burst tears don't inherit them.
  • 15►Polyphemus Polyphemus: The main tear gains the semi-piercing ability and may not burst when hitting a weaker enemy. Split tears do not semi-pierce.
  • 15►Pop! Pop!: Tears no longer arc, but will still burst when hitting an obstacle or stopping and falling to the ground.
  • 15►Sinus Infection Sinus Infection: 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.
  • 15►Tractor Beam Tractor Beam: The main tear follows the beam, but the burst spreads normally.

In-game Footage[edit | edit source]

Gallery[edit | edit source]

Trivia[edit | edit source]

  • Haemolacria has been added in Booster Pack #4, after the initial release of the DLC.
  • Haemolacria is based on this Steam Workshop item by HiHowAreYou, originally known as Water Balloon.
  • The item is a reference to Haemolacria, a rare condition that causes people to produce tears that are composed of blood.

Seeds[edit | edit source]

PC Greed mode only 7RQR CJAB (First floor Golden Treasure Room)

XboxOne Normal mode only JGW6 YMVT

SwitchHard mode only WMAP AJ87 (First floor Treasure Room)

PC Normal and hard modes only L2DY 29AC (Treasure Room adjacent to spawn)

Bugs[edit | edit source]

Bug Bug! When using The Forgotten's melee attack with both Jacob's Ladder and Haemolacria, the sparks caused by splattered tears will hurt the player. (Video clip)
Bug Bug! Using Mom's Knife and Marked with Haemolacria will cause it to only fire towards the center of room, using the fire buttons will barely move the Marked icon; while Mom's Knife will be unusable and locked to the right.

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