A familiar who will drop a half red heart every 2 rooms.
A familiar that mirrors the player's movements and shoots in the opposite direction.
Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
The Ludovico Technique
Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
Sets your key count to the maximum of 99.
+1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.
Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.
Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
Spawns a white poop familiar, which turns into a white poop when Isaac is hurt.
Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Spawns a familiar that follows Isaac around and fires spectral tears.
Increases speed and reduces character size. Also gives a random pill.
Transforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).
Ball of Tar
Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
Allows Isaac to fire tears from the back of his head.