Item: Tarot Cloth
Grants quadruple shot but decreases tears.
Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
Adds a chance to fire a booger which sticks to enemies and poisons them.
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.
A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
Grants one bone heart and spawns three red heart pickups.
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.
The Black Bean
When taking damage, Isaac farts, causing poison damage to all enemies in range.
Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Increases range and shot speed, while adding 1 Black Heart.
Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Gives Isaac's tears a boomerang effect, and increases range and shot speed.
Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.