NAA10 encodes for the enzyme NAA10, which is the catalytic subunit in the N-terminal acetyltransferase A (NatA) complex. N-alpha-acetylation is one of the most common co-translational protein modifications in humans and is essential for normal cell function. The auxiliary and regulatory subunits of the NatA complex are NAA15 and Huntington-interacting protein (HYPK), respectively. Through a genotype-first approach with primarily exome sequencing, one clinician identified and interviewed the parents of 56 individuals with NAA10 variants and 19 individuals with NAA15 variants. Clinical features of affected individuals include variable levels of intellectual disability, delayed speech and motor milestones and autism spectrum disorder, which are usually more severe in individuals with NAA10 variants compared to those with NAA15 variants. Additionally, some individuals present with mild craniofacial dysmorphology, congenital cardiac anomalies and seizures. The majority of individuals with NAA10 variants present with visual abnormalities, which often include astigmatism, myopia, strabismus, amblyopia, and/or cortical visual impairment. Further, there are a subset of individuals who have exotropia/esotropia, microphthalmia, blindness, and/or have abnormalities to the optic disc or nerve. In individuals with NAA15 variants, visual abnormalities were present in a small subset with strabismus, amblyopia, astigmatism, and other visual impairment, with many individuals affected by this syndrome wearing eyeglasses. We discovered a female (Individual 23) with the common p.Arg83Cys variant, yet she is the only female published to date who was born with microphthalmia, along with stigmatism in her left eye, myopia and possible cortical visual impairment. We report another male with microphthalmia with a frameshift p.Thr152Argfs*6 variant in NAA10. Vineland-3 functional assessment demonstrates that the overall level of functioning for the probands with NAA15 variants was significantly higher than the probands with NAA10 variants. When the results for NAA10 are separated by sex, inheritance pattern, and variant type, it is clear that the frameshift variants located toward the C-terminal end of NAA10 have much less impact on overall functioning. The females with the p.Arg83Cys missense in NAA10 have a similar level of impairment to the females with other missense changes in NAA10. The overall data are consistent with a phenotypic spectrum for these alleles involving multiple organ systems, including visual development, and as such we suggest that the condition involving NAA10 should be interchangeably referred to as Ogden syndrome and/or NAA10-related neurodevelopmental syndrome, and the condition involving NAA15 should be referred to as NAA15-related neurodevelopmental syndrome.