So, items won't appear when I start the game until I save and quit, then load again. Even then, it will only let me pick up the items my cursor was over before I quit, and won't let me pick up anything else. The cursor doesn't appear when I scroll over them, and spam clicking doesn't work. How do I fix this?

So you are both unable to pick up and see most items? Strange.
Does everything else in the game work fine? Can you use and see buttons and keycard slots? Are there any invisible and tangible materials? I don't think the culprit would be any other than your video card for the latter.
Otherwise, I guess you can try setting operating system for the executable to XP Service Pack 3 and tick "Run as Administrator" in the compatibility tab, and make the game's folder not read only.

Yeah, everything else works fine. The SCPs are still as eager to kill me as usual, and I can open doors that don't need keycards. (Of course I can't get any). I'll try running it as administrator and check back, thanks.

I tried going down into the tunnels to find that the game crashes when I encounter 049. Tried running game as admin and playing again, but it still crashes, and same thing as originally mentioned happens. Thank you for trying to help, though! (Maybe it's broken on Windows 8?)

Purplbix wrote:I tried going down into the tunnels to find that the game crashes when I encounter 049.

Fixed