My Reflection 
Effects
- Isaac's tears travel a short distance, then reverse direction and return to Isaac.
- The tears are constantly pulled towards Isaac; if Isaac moves after shooting, the tears will always return to him.
- (Removed in Repentance) +1.5 range.
- (Added in Repentance) 1.6x+1.5 range.
- 1.6x shot speed multiplier.
- +1 tear height.
Interactions
Anti-Gravity: The tears will slowly move towards Isaac instead of remaining stationary. Releasing the fire button will launch the tears as usual.
Brimstone: Overrides My Reflection.
- (Added in Afterbirth) Makes the beam curve when moving. It has the same effect on Azazel's mini-brimstone and doubles the range.
- (Added in Repentance) The laser makes a thin loop in front of Isaac, and fires the normal laser backwards.
- (Added in Afterbirth)
Continuum: If tears cross the border of the room, they will move towards Isaac from their new position rather than crossing back across the border.
- (Added in Afterbirth †)
Compound Fracture /
The Parasite/
Cricket's Body: Split tears will move towards Isaac.
Dr. Fetus: Not recommended. The bombs will slide back towards Isaac after having reached a certain distance.
- When combined with (Added in Repentance)
Rocket in a Jar, the rockets will not explode unless they hit an obstacle or enemy, making this much safer.
Epic Fetus: Overrides My Reflection.
- (Added in Afterbirth †)
Euthanasia: Needles from Euthanasia bursts will move towards Isaac.
- (Added in Afterbirth †)
Flat Stone: Tears bounce away from and then back towards Isaac.
- (Added in Afterbirth †)
Haemolacria: 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.
Ipecac: Not recommended. The explosive tears will begin flying back towards Isaac after having reached a certain distance.
- (Added in Afterbirth †)
Lachryphagy: Tears will move towards Isaac and can still be fed and burst. The bursted tears will also move towards Isaac.
A Lump of Coal: The tears increase in damage as they are pulled towards Isaac.
The Ludovico Technique: The tear will slowly move towards Isaac, and the shot speed increase allows the tear to be moved much faster.
Mom's Knife: No effect, as the knife already has this effect.
- (Added in Repentance)
Montezuma's Revenge: Causes the beam range behind Isaac to become significantly increased as well as having a short range similar to Azazel's beam in front of him. This greatly eases the use of this item allowing for high DPS.
My Reflection: No further stat changes.
- Piercing tears: Despite the piercing effect, tears cannot damage the same enemy multiple times.
- (Added in Afterbirth †)
Pop!: Tears can still bounce off of each other but will try to return to Isaac.
Proptosis: At base tear size, tears disappear before they can return to Isaac.
- (Added in Repentance)
Pupula Duplex: Tears will spin like boomerangs, the effect is purely cosmetic.
- (Added in Repentance)
Revelation: The laser makes a thin loop in front of Isaac, and fires the normal laser backwards.
Rubber Cement: Isaac's tears will continually be pulled towards him, effectively reducing the chances that tears will bounce.
Spoon Bender: If tears are close enough to an enemy, it will home in and damage them. If not, they will return to Isaac.
Strange Attractor: Not recommended. While it may make it easier to hit enemies, it also makes it much easier for them to be attracted to Isaac, surrounding him.
Technology: Overrides My Reflection.
- (Added in Afterbirth) Makes the beam curve when moving.
Technology 2 /
Tech.5
- (Removed in Repentance)Tears return to character and the beams curve when moving.
- (Added in Repentance) The laser makes a thin loop in front of Isaac, and fires the normal laser backwards.
- (Added in Afterbirth)
Tech X: Stat effects of My Reflection remain but the boomerang effect does not.
Tiny Planet: The orbital tears will move faster to stay in orbit around Isaac, making aiming easier.
- (Added in Afterbirth †)
Trisagion: Makes the beams much longer as they move away from and then back towards Isaac.
- (Whip Worm) Whip Worm: Further increases shot speed, making Isaac's tears travel much farther forward before returning to Isaac.