Modern imaging sensors allow for high granularity optical readout of radiation detectors such as MicroPattern Gaseous Detectors (MPGDs). Taking advantage of the high signal amplification factors achievable by MPGD technologies such as Gaseous Electron Multipliers (GEMs), highly sensitive detectors can be realised and employing gas mixtures with strong scintillation yield in the visible wavelength regime, optical readout of such detectors can provide high-resolution event representations. Applications from X-ray imaging to fluoroscopy and tomography profit from the good spatial resolution of optical readout and the possibility to obtain images without the need for extensive reconstruction. Sensitivity to low-energy X-rays and energy resolution permit energy resolved imaging and material distinction in X-ray fluorescence measurements. Additionally, the low material budget of gaseous detectors and the possibility to couple scintillation light to imaging sensors via fibres or mirrors makes optically read out GEMs an ideal candidate for beam monitoring detectors in high energy physics as well as radiotherapy. We present applications and achievements of optically read out GEM-based detectors including high spatial resolution imaging and X-ray fluorescence measurements as an alternative readout approach for MPGDs. A detector concept for low intensity applications such as X-ray crystallography, which maximises detection efficiency with a thick conversion region but mitigates parallax-induced broadening is presented and beam monitoring capabilities of optical readout are explored. Augmenting high resolution 2D projections of particle tracks obtained with optical readout with timing information from fast photon detectors or transparent anodes for charge readout, 3D reconstruction of particle trajectories can be performed and permits the realisation of optically read out time projection chambers. Combining readily available high performance imaging sensors with compatible scintillating gases and the strong signal amplification factors achieved by MPGDs makes optical readout an attractive alternative to the common concept of electronic readout of radiation detectors. Outstanding signal-to-noise ratios and robustness against electronic noise allow unprecedented imaging capabilities for various applications in fields ranging from high energy physics to medical instrumentation.