Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
When hit, summons a white attack fly similar to Distant Admiration for the current room.
Spawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.
Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.
Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
Spawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.
Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
An angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
Cain's Other Eye
Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeperand shoots normal tears in the same direction as Isaac.
Spawns a blue attack fly that orbits a long distance from Isaac.
Ball of Bandages
Orbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.
Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Isaac's tears have a chance to stick to enemies and explode.
Grants Isaac one red heart container and fully restores Isaac's health.
Adds 3 black hearts and increases Damage by 1.