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What's going in varies too much for a lemmy length response. There's dozens of possible causes.
Testing is fairly simple though. The doctors will check for observable factors. If the pupil responds to light, if the eyes track movement, if the eyes move together, or wander. They can check the retina for issues, as well as the rest of the anatomy of the eye.
As example, just shining a small, focused light is enough to check for pupil response, as well as blinking or other signs that the brain is getting signals from the eye, as well as whether or not the eye is working as it's supposed to.