Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Grants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.
Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Adds 3 black hearts and increases Damage by 1.
Increases Damage and Speed, plus adds one Soul Heart.
After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Gives a random chance for projectiles to fire in all 4 cardinal directions.
Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Grants one red heart container, restores 5 red hearts, and increases speed by 0.3.
Displays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
Eye of Greed
Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Head of the Keeper
Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.