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The tears now deal between .66x and 2.00x of Isaac's damage, and the tear size multiplier is now 1.0x to 2.0x.
Sad Bombs - Bombs now create a single volley aimed at the nearest enemy instead of a ring of tears.
Varicose Veins - similar to Sad Bombs
Tammy's Head - ditto
Trisagion: Fires a shotgun spread of Tri-lasers.
Ludivico: Creates a ring of 14 small tears, tear movement is slower then normal.
Hemoptysis: Perform a large sneeze similar to T!Azazel's birthright sneeze upon releasing the charge.
There heads fuse together and has a double monstro lung
Vasculitis: Dead enemies fire barrages at nearby enemies.
Montezuma's Revenge: The beam is replaced with a barrage of tears that leaves brown creep on the ground.
Epiphora: Charging the barrage over maximum adds more tears to the barrage and makes the tears fire out faster.