Microelectronic imager assemblies comprising a workpiece including a substrate and a plurality of imaging dies on and/or in the substrate. The substrate includes a front side and a back side, and the imaging dies comprise imaging sensors at the front side of the substrate and external contacts operatively coupled to the image sensors. The microelectronic imager assembly further comprises optics supports superimposed relative to the imaging dies. The optics supports can be directly on the substrate or on a cover over the substrate. Individual optics supports can have (a) an opening aligned with one of the image sensors, and (b) a bearing element at a reference distance from the image sensor. The microelectronic imager assembly can further include optical devices mounted or otherwise carried by the optics supports.