Brimstone - Tear takes the shape of a very large laser ring. The shot speed is ignored. The Tears stat is ignored and the damage is dealt very rapidly at a rate equivalent to 1 tear delay. This ring will always be present and doesn't need charging up like normal Brimstone would.
Incubus: Incubus' Brimstone laser is not affected by Ludovico Technique.
Ipecac: +2 damage, beam explodes when colliding with enemies and obstacles
A Lump of Coal: The ring increases in diameter, but not the damage, the farther away it gets from Isaac.
Spoon Bender: The ring reaches out to attack enemies near it, reforming into a ring when no enemies are present.
Technology: The ring is visually identical to a normal Brimstone ring, but the 1.5x damage multiplier applies.
Compound Fracture - Turns tear into a large bone, which shoots out smaller tears when attacking/touching an enemy. Scattered tears are spectral and piercing.
Dead Eye - Damage bonus increases until it hits the max of 2x. Since the controllable tear never hits the ground or wall, the bonus cannot be lost.
Flat Stone - The tear starts bouncing at a rate somewhat below Isaac's fire rate, each bounce dealing splash damage.
Flat Stone +
Ipecac: Causes a poisonous explosion when it bounces instead of plain splash damage, as per normal Ipecac. The first bounce when entering a room does not explode, allowing moving the tear with less risk of self-damage.
Godhead - The tear homes towards nearby enemies and gains a large damaging aura. However, the aura cannot damage an enemy that is in contact with the actual tear; barring a high tear rate, it may be better to keep the aura on the enemies instead of the tear.
Incubus - Isaac gains a controlled tear while also being able to shoot normally with Incubus. Incubus's tears gain piercing and spectral properties.
Incubus creates a second smaller Ludovico Technique tear instead, which can both be controlled by Isaac. The second tear is slightly delayed/ outside of the main tear. This may cause it to not hit enemies sometimes.
Loki's Horns - The Ludovico tear will sometimes shoot 4 smaller tears in each direction.
Lost Contact - Tear will block enemy tears without disappearing.
A Lump of Coal - The tear becomes larger the further away it is from Isaac, increasing in damage.
Mom's Eye - The Ludovico tear will sometimes shoot a smaller tear in a random direction.
Monstro's Lung - Tear turns red and does more damage.
Tear becomes a cluster of variously sized tears spread over a small area. The tears move at the same speed when controlled but constantly move around each other.
The Parasite - Shoots out smaller tears when attacking an enemy. Scattered tears are spectral and piercing.
Pause - The tear deals damage, even if the enemies are stopped. Moving the tear unpauses the enemies.
Strange Attractor - Enemies, items and even most bosses will be sucked to the single floating tear, dealing constant damage while keeping Isaac well away from harm, making this combination extremely effective in almost all scenarios.
Lodestone - The single floating tear will flash grey to indicate that the magnetism might apply on hit. Like Strange Attractor, enemies tagged with magnetism will also draw the floating tear towards said enemy
Technology - The tear becomes a large laser ring, which visually looks like a shot fired by
Tech X. Shot speed is ignored. The Tears stat is ignored and the damage is dealt very rapidly at a rate equivalent to 1 tear delay.
Tech.5 - The tear controls as usual, and Isaac fires the laser towards the tear relative to his position, rather than in the direction the player is moving the tear.
Tear Detonator - The tear explodes into six smaller tears, then reappears next to the player.