Isaac emits a beam in the direction that his head is facing. Isaac's tears travel in the path of the beam. When Isaac moves or turns his head, tears that are mid-flight will remain within the beam.
Continuum: The tears will re-appear directly in front of Isaac and continue their flight path after going off screen.
Guillotine: The beam will visually follow Isaac's head as it orbits, but tears will still stay centered relative to Isaac's body making his tears easier to aim.
Lachryphagy: Tears can still be fed and will still burst. Burst tears will travel along the beam.
Monstro's Lung: All tears are fired along the beam but at different heights.
Ouroboros Worm: The altered patterns tears travel in is confined to the beam allowing Isaac to benefit from the stat bonus and spectral tears granted without losing accuracy.
Pop!: Tears stick along the tractor beam even when they slow down and collide, capable of creating a dense line of shots.
Rainbow Worm: The altered patterns tears travel in is confined to the beam allowing Isaac to benefit from the stat bonuses granted without losing accuracy.
Many of the worm trincket effects it gives now grants spectral tears as well.
Ring Worm: The altered pattern tears travel in is confined to the beam allowing Isaac to benefit from its stat bonus and spectral tears without losing accuracy.
Rubber Cement / Super Ball: Tears will no longer be bound to the beam after bouncing off of something.
Sinus Infection: Once the booger falls off the enemy, Isaac can loosely control it by moving and firing in different directions, and make it stick to another enemy.
C Section: Overridden by C Section. Stat effects apply.
Dr. Fetus: After firing a bomb and moving, the bomb will have a homing-style effect towards the beam, but will not stay directly on the beam. Not recommended, as changing directions while firing will cause the bomb to reel back to Isaac at high speed, making self-damage very likely.
Euthanasia: Needles fired will follow beam; however, burst needles will not.
Evil Eye: Both evil eyes and tears fired by them will not be affected by the beam.
Explosivo: Explosivo's tears will become "entangled" when sticking on an enemy, causing them to jump from the tractor beam to the enemy and vice versa every frame. The tear will explode only once regardless while attached to an enemy or bound to the beam.
Eye of the Occult: Tears will only move forward while being fired, but control is otherwise overridden.
This item is a reference to tractor beams in science fiction, often depicted as beams of energy that can be used to move objects.
Bugs
Bug!
Tractor Beam has unusual effects when combined with Continuum and Pop!.[1] While shooting, tears will appear for brief moments at the back of Isaac's head, and if he hits an enemy with one of these, that enemy will be teleported to a corner of the screen for poorly understood reasons. Isaac himself can also get teleported to a corner, resulting in a potential softlock without flight or How to Jump.