Spawns a familiar that slowly charges forward and damages enemies in its path.
Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
Creates a ring of light around Isaac that petrifies enemies in contact.
When hit, spawns up to 2 blue spiders.
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Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
When hit, summons a white attack fly similar to Distant Admiration for the current room.
Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Spawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider.
Spawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.
Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.
Tears up, adds 1 soul heart, and decreases Isaac's size.
Allows Isaac to fire tears from the back of his head.
Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.
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.
+0.3 tears up. Allows Isaac to fire tears diagonally.
Increases Damage by 1 and adds a chance to shoot fear tears.
Causes Isaac's activated item to activate twice on each use.