The differential diagnosis of conjunctival lesions include complexion-associated melanosis (CAM), nevus, primary acquired melanosis (PAM), and melanoma.1 Most conjunctival melanomas arise from precursor lesions, with approximately 75% arising from PAM with atypia and less than 10% from nevi.2 De novo cases account for 15%25% of occurrences.2 The incidence of conjunctival melanoma is increasing, with a risk of death of around 30%.3 Complexion-associated melanosis lesions pose no malignancy risk, are often bilateral (though are sometimes asymmetric) and predominantly located perilimbally, and are more common in individuals with darker-pigmented skin (Figure 1).1 In contrast, PAM lesions are typically unilateral, flat, variably pigmented, with potential change in size and shape over time, and, most importantly, have malignant potential (Figure 3).4 Primary acquired melanosis lesions are, by definition, acquired and may present as new pigmentation on the ocular surface

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Harmeyer, Metabolic functions of L-carnitine and its effects as feed additive in horses
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However, horses with digestive disturbances, high-grain diets, or antibiotic use may benefit from additional supplementation to maintain optimal nutrient utilization