Upon picking up 3 items from the following list, Isaac will fire tears out of both eyes simultaneously 25% of the time. This effect stacks with items such as 20/20, The Inner Eye and Mutant Spider, multiplying the number of tears.
The chance of firing double tears is not affected by luck.
Adds 1 Soul Heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).
Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.
Increases damage by 2 for the current room, also granting a 1.5x damage multiplier if Isaac has Blood of the Martyr. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Increases the chance by 12.5%.