Continuum - When tears pass through solid objects, like rocks, they will split, resulting in many tears shooting out from every rock the original tear passed through.
Cricket's Body - Two groups of this item's four tears, creating eight additional miniature tears on every point of impact instead.
Dr. Fetus - Bombs split into two bombs upon detonation.
Flat Stone - Every time tears bounce, burst tears spawn.
Lachryphagy - Fed tears split into 12 tears. When tears are minimally fed and hit an obstacle, they will split into 5 Lachryphagy burst tears and Parasite burst tears.
Lead Pencil - All tears in tear barrage will burst into split tears when hitting obstacles or enemies.
Monstro's Lung - All tears in tear barrage will burst into split tears when hitting obstacles or enemies.
The Ludovico Technique - Repeatedly spawns miniature tears when on top of an enemy, greatly increasing damage.
Tiny Planet - The split tears will continue to orbit Isaac, increasing damage potential.
Tractor Beam - The split tears will be forced directly forward, impacting whatever caused the first tear to split. This increases damage immensely.
If all shots connect, total damage will be multiplied by (2 + n), where n is the exponent in the highest power of 2 that is equal to or less than your damage. For example, at 12 damage, the greatest power of 2 lower than your damage is 8. 8 is 2³, so total damage will be multiplied by 2 + 3, or 5.
Trisagion - When beams hit obstacles, the beam will split; the split beams can split again when hitting other obstacles.
Brimstone - 2 beams will be fired perpendicular to the main beam at the closest point of intersection with an enemy or obstacle.