Adds a chance to fire a gas cloud that damages nearby enemies.
Increases range and shot height.
Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Tears have a chance to charm enemies.
Increases speed and reduces character size. Also gives a random pill.
Lord of the Pit
Grants flight and increases speed.
Destroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.
Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
A familiar that follows Isaac around shooting blood tears.
Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Spawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.
Spear of Destiny
In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
A familiar that mirrors the player's movements and shoots in the opposite direction.
Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.